Cost Avoidance definition

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.

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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. 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.

Examples of Cost Avoidance in a sentence

• Third Party Health Insurance Cost Avoidance Claims Amount by Carrier b.

• To the extent permitted by State and federal law, the Contractor shall use Cost Avoidance processes to ensure that primary payments from the liable third party are identified, as specified below.

• HONEYWELL will use energy auditing software to track monthly facility costs, energy consumption, and Energy Cost Avoidance and to quantify and report on changes in energy usage due to changes in billing periods and weather.

• Pursuant to section 10.4 the MCO shall report all recovery and Cost Avoidance amounts on the encounter claim as Third Party Liability payments.

• Option A methods will be applied on an ECM specific basis (i.e., isolated to the retrofit) and Energy Cost Avoidance for a Guarantee Year will be quantified and summarized on an ECM basis.

More Definitions of Cost Avoidance

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.

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 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

Cost Avoidance means a claims processing edit, which rejects a claim, when there is an identified liable third party.

Cost Avoidance means the difference between current and baseline cost, baseline cost being what current cost would have been had no energy efficiency measures

Cost Avoidance means refers to the process of identifying and

Cost Avoidance means avoiding payment of claims when first--or third-party payment sources are available.