Member Privacy Rights

UM decisions are based on medical necessity, which includes appropriateness of care and services and the existence of available benefits.

SBH does not specifically reward health plan staff, providers and practitioners or other individuals for issuing denials of coverage, care or service. Incentive programs are not utilized to encourage decisions that result in under-utilization; and there is no conflict of interest between SBH and its UM decision-makers.

Privacy Practices