Review of Utilization Data. Contractor shall include within the UM program mechanisms to detect both under- and over-utilization of health care services. Contractor’s internal reporting mechanisms used to detect Member utilization patterns shall be reported to DHCS upon request.
Appears in 7 contracts
Samples: www.dhcs.ca.gov, www.dhcs.ca.gov, www.dhcs.ca.gov
Review of Utilization Data. 2.11.8.1. Contractor shall include within the UM utilization management program mechanisms to detect both under- and over-over- utilization of health care services. Contractor’s internal reporting mechanisms used to detect Member Enrollee utilization patterns shall be reported to DHCS upon request.
Appears in 5 contracts
Samples: www.cms.gov, calduals.org, calduals.org
Review of Utilization Data. 2.11.7.1. Contractor shall include within the UM utilization management program mechanisms to detect both under- and over-over- utilization of health care services. Contractor’s internal reporting mechanisms used to detect Member Enrollee utilization patterns shall be reported to DHCS upon request.
Appears in 2 contracts
Samples: www.cms.gov, www.cms.gov
Review of Utilization Data. Contractor shall include within the UM program mechanisms to detect both under- and over-utilization of health care services. Contractor’s internal reporting mechanisms used to detect Member Enrollee utilization patterns shall be reported to DHCS upon request.
Appears in 1 contract
Samples: www.acgov.org
