Cost Avoidance. A method of paying Claims in which the Provider is not reimbursed until the Provider has demonstrated that all available health insurance has been exhausted.
Cost Avoidance means the difference between the actual cost incurred during a selected time period versus what the cost would have been had the ECM not been implemented, including without limitation avoided, defrayed, or reallocated costs.
Cost Avoidance. A method of paying Claims in which the Provider is not reimbursed until the Provider has demonstrated that all available health insurance, and other sources of Third Party Liability, have been exhausted. Countersignature: An authorization provided by the Enrollee’s PCP, or another Provider within the Enrollee’s PMG, for a prescription written by another Provider to be dispensed. No Countersignature shall be required if the Provider writing the prescription is within the PPN.
Examples of Cost Avoidance in a sentence
DIR Cost Avoidance As part of the performance measures reported to state leadership, DIR must provide the cost avoidance the State has achieved through the Contract.
DIR Logo 12 Vendor and Order Fulfiller and Reseller Logo 12 Trade Show Participation 13 Orientation Meeting 13 Performance Review Meetings 13 DIR Cost Avoidance 13 8.
Third Party Health Insurance Cost Avoidance Claims Amount by Carrier b.
Cost Avoidance Claims: This report consists of all Claims during the month that have been identified as having Third Party coverage leading to cost avoidance by the MCO.
The two methods used for coordination of benefits are Cost Avoidance and Post-Payment Recovery.
More Definitions of Cost Avoidance
Cost Avoidance. The application of a range of tools to identify and prevent inappropriate or medically unnecessary charges before they are actually paid. This may include service authorization, second surgical opinion, medical necessity review, and other pre-and post- payment /service reviews. “Cost Sharing” Co-payments paid by the member in order to receive medical services. “COV Security Standards” Commonwealth of Virginia (COV) Information Technology Resource Management (ITRM) policies, standards, and guidelines that may be updated from time to time. A complete list can be located at xxxx://xxx.xxxx.xxxxxxxx.xxx/library/default.aspx?id=537.
Cost Avoidance. The application of a range of tools to identify and prevent inappropriate or medically unnecessary charges before they are actually paid. This may include service authorization, second surgical opinions, medical necessity review, and other pre-and post- payment / service reviews. “Cost Sharing” Co-payments paid by the member in order to receive medical services. “COV Security Standards” COV Information Technology Resource Management (ITRM) policies, standards, and guidelines that may be updated from time to time. A complete list can be located at xxxx://xxx.xxxx.xxxxxxxx.xxx/library/default.aspx?id=537.
Cost Avoidance means the Government special education cost reduction for one Cohort of children. It is calculated by multiplying reported operating cost reductions by the Measurement Error Discount.
Cost Avoidance means the difference between the actual cost incurred during a selected time period versus what the cost would have been had the cost avoidance strategy not been implemented.
Cost Avoidance. The application of a range of tools to identify and prevent inappropriate or medically unnecessary charges before they are actually paid. This may include service authorization, second surgical opinions, medical necessity review, and other pre-and post- payment / service reviews. “Cost Sharing” Co-payments paid by the member in order to receive medical services.
Cost Avoidance means a method used by HCA to avoid payment when other primary insurance resources are available to the Enrollee. When claims are submitted on behalf of Enrollees who have other primary insurance on file, payment will be denied and claims returned to the providers, who are then required to bill and collect payment from any liable third parties. (42 C.F.R. § 433.139(b)).
Cost Avoidance means a claims processing edit, which rejects a claim, when there is an identified liable third party.