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: Service Agreement, Healthcare Agreement, Service Agreement
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
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
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 2 contracts
Samples: Contract for Low Income Health Program, Contract for Low Income Health Program
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 CDHS upon request.
Appears in 1 contract
