Arena Health Affirmative Statement
 

Arena Health is committed to supporting medically appropriate, evidence-based care for every member we serve. Utilization Management (UM) decisions are made solely on the basis of medical necessity, clinical appropriateness, and applicable health plan coverage.
 

Arena Health does not provide financial incentives or rewards to physicians, practitioners, reviewers, or staff for denying or limiting medically necessary services. Likewise, no provider or practitioner is discouraged from advocating for the care they believe is appropriate for their patients.
 

Participating physicians are free to recommend, request, and authorize medically necessary services without concern for compensation, employment status, or any form of retaliation. Our Utilization Management processes are designed to support quality patient care while ensuring fair, consistent, and objective clinical decision-making.
 

Members and providers may request a copy of the clinical criteria or guidelines used in making a Utilization Management determination by contacting Arena Health Member Services at 909-667-2177.

 

Impartiality Statement
 

Arena Health is committed to maintaining fairness, objectivity, and professional independence throughout the Utilization Management process. Participating physicians and healthcare practitioners retain full clinical independence when making treatment recommendations and referral decisions. Clinical judgment is never influenced by employment considerations, compensation, promotion, credentialing, or any other administrative or financial factors.

Arena Health supports providers in making decisions based solely on the individual healthcare needs of each patient, consistent with accepted standards of medical practice.

 

All Care To You (ACTY) Affirmative Statement
 

All Care To You (ACTY), on behalf of its client healthcare professionals, supports the appropriate utilization of medically necessary healthcare services while discouraging both overutilization and underutilization of care.
 

Utilization Management decisions are based exclusively on medical necessity, clinical appropriateness, and applicable health plan coverage. ACTY does not reward healthcare professionals, reviewers, or staff for denying services or restricting access to medically necessary care.
 

Providers and practitioners remain free to advocate for their patients and may recommend or authorize medically appropriate services without fear of penalty or adverse action.
 

All Care To You (ACTY) Impartiality Statement
 

ACTY is committed to ensuring impartial, independent clinical decision-making throughout the Utilization Management process.
 

Participating practitioners exercise independent professional judgment when making treatment and referral decisions. These decisions are made without influence from hiring practices, compensation, promotion, termination, or any other employment-related consideration, ensuring that patient care remains the highest priority.