Affirmation Statement

Landmark’s utilization review process monitors patient care to ensure patients receive the most effective care that results in the best outcomes. Accordingly, Landmark affirms that:

• Our Clinical Peer Reviewers make authorization decisions based on the appropriateness of the requested care and services.
• No one at Landmark is compensated in any way for denying, limiting or modifying care.
• Landmark does not provide any type of incentive to our Clinical Peer Reviewers or consulting committee members to encourage making decisions that modify, reduce or deny services.
• Landmark prohibits making decisions regarding hiring, promoting or terminating practitioners or other individuals based on the likelihood or perceived likelihood that the individual will support or tend to support a denial of benefits.

Review determinations are not arbitrary. All information submitted on your Treatment Plan Form (authorization request) or by other means of clinical documentation is considered.  Authorization decisions are based on Landmark's Clinical Practice Guidelines, scientific evidence, research literature and similar cases in Landmark's collective experience.