Cost Containment Features Clause Samples
The Cost Containment Features clause establishes mechanisms within a contract to control and limit expenses associated with the agreement. Typically, this clause may set spending caps, require pre-approval for certain expenditures, or outline procedures for monitoring and reporting costs. Its core practical function is to prevent unexpected or excessive financial outlays, thereby protecting the parties from budget overruns and ensuring financial predictability throughout the contract term.
Cost Containment Features. This Plan contains at least the following cost containment provisions: Preventive healthcare benefits. HPN’s Managed Care Program. Benefit limitations on certain services. Member Copayments.
Cost Containment Features. The AOC contains a number of cost containment provisions including, but not limited to:
(a) Second and Third Opinions/Consultations;
(b) Preventive healthcare benefits;
(c) Plan Provider benefit incentives as described in Attachment A Benefit schedule; and
(d) SHL’s Managed Care Program.
Cost Containment Features. This Plan contains a number of cost containment provisions including, but not limited to: (a). Second surgical opinions;
Cost Containment Features. HPN has the right to collect payments for healthcare services made in error. Hospitals, Physicians, other Providers, and/or the Subscriber have the responsibility to return any overpayments or incorrect payments to HPN. HPN has the right to offset any overpayment against any future payments. This Plan contains at least the following cost containment provisions:
(a) Preventive healthcare benefits.
(b) HPN’s Managed Care Program.
(c) Benefit limitations on certain services.
(d) Member Copayments. Each Member authorizes the Physician, Hospital, Skilled Nursing Facility or any other Provider of healthcare to permit the examination and copying of the Member's medical records, as requested by HPN. Information from medical records and information received from Physicians or Hospitals incident to the Physician/Patient relationship or Hospital/Patient relationship shall be kept confidential and except for use in connection with government requirements established by law or the administration of this Plan, records may not be disclosed to any unrelated third party without the Member’s consent.
Cost Containment Features. HPN may request additional information to determine whether to approve or deny the claim. HPN shall notify the Provider of its request for additional information within twenty (20) days after receipt of the claim. HPN will notify the Provider of the healthcare services of all the specific reasons for the delay in approving or denying the claim.
Cost Containment Features. If the laws of the jurisdiction of issue do not designate the maximum length of time in which such action may be brought, no action may be brought after three (3) years from the time within which proof of loss is required by the AOC.