Aetna does not make employment decisions or reward
physicians or other individuals who conduct utilization reviews
for issuing denials of coverage or for creating barriers to care
or service. Financial incentives for utilization management
decision-makers do not encourage denials of coverage or
service. Rather, we encourage the delivery of appropriate
health care services. In addition, we train Utilization Review
staff to focus on the risks of under-utilization and
over-utilization of services.