Cost Avoidance Procedure definition

Cost Avoidance Procedure means the following techniques to ensure benefit coordination and by which the MCO ensures that a Provider obtains payment from the identified Third Party Liability resources before billing the MCO. MCO coverage is secondary to other health coverage for which Enrollees are eligible; coverage by all potential third-party payers must be exhausted before MCO payment for health services will be made. An eligible provider must attempt to collect payment from potential third-party payers before billing the MCO for Covered Services; private accident and health care coverage must be used according to the rules of the specific carrier.
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Cost Avoidance Procedure means the process by which a Provider obtains payment from the identified third party resource before billing the MCO.
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Cost Avoidance Procedure means the process by which a provider obtains payment from the identified third party resource before billing the HEALTH PLAN.
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Related to Cost Avoidance Procedure

  • Grievance Procedure is used in this Agreement, it shall be considered as including the arbitration procedure.

  • Recovery Plan means a recovery plan drawn up and maintained by an institution in accordance with Article 5;

  • Variation Procedure means the procedure for carrying out a Variation as set out in Clause 16.1 (Variation Procedure);

  • Direct Ordering Procedure means the ordering procedure set out in paragraph 2 of Schedule 5 (Ordering Procedure) of this Framework Agreement;

  • Cost Allocation Plan means central service cost allocation plan, public assistance cost allocation plan, and indirect cost rate proposal. Each of these terms are further defined in this section.

  • Day Case Procedure means a Medically Necessary surgical procedure for investigation or treatment to the Insured Person performed in a medical clinic, or day case procedure centre or Hospital with facilities for recovery as a Day Patient.

  • Implementation Period means the period from the date of signing of the Agreement and up to the issuance of Final Acceptance Certificate for the project.

  • Maintenance Program means a maintenance program for the Aircraft approved by the Aviation Authority, in conformity with the Maintenance Planning Document.

  • Business Continuity and Disaster Recovery Plan means the Schedule containing plans and provisions for business continuity and disaster recovery.

  • Aversive procedure means a systematic physical or sensory intervention program for modifying the behavior of a student with a disability which causes or reasonably may be expected to cause one or more of the following:

  • Section 385 Expanded Group shall have the meaning set forth in Treasury Regulation Section 1.385-1(c)(4) for an “expanded group”.

  • Management Plan means a plan to manage the activities and protect the special value or values in an Antarctic Specially Protected Area or an Antarctic Specially Managed Area.

  • Resettlement Plan or “RP” means the resettlement plan for the Project, including any update thereto, prepared and submitted by the Borrower and cleared by ADB;

  • Project Implementation Plan means the detail plan submitted by the Developer with regard to development of Project Facilities and its operation and management thereof in accordance with this Agreement and to be appended as Schedule 9 to this Agreement.

  • Implementation Plan means the schedule included in the Statement of Work setting forth the sequence of events for the performance of Services under the Statement of Work, including the Milestones and Milestone Dates.

  • Implementation Schedule means the Implementation Schedule in Section VII of the tendering documents.

  • Implementation Date means the date, occurring after the Approval Date, on which the Merger is implemented by the Merging Parties;

  • Standard operating procedure means a formal written procedure offi- cially adopted by the plant owner or operator and available on a routine basis to those persons responsible for carrying out the procedure.

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).

  • Administrative Procedures means the Administrative Procedures of Minnesota Management & Budget developed in accord with M.S. 43A.04, subdivision 4.

  • Plan Implementation Date means the Business Day on which all of the conditions precedent to the implementation of the Plan have been fulfilled, or, to the extent permitted pursuant to the terms and conditions of the Plan, waived, as evidenced by the Monitor’s Plan Implementation Date Certificate to be filed with the Court;

  • Change Control Procedure has the meaning set out at Clause 28.1;

  • Disaster Recovery Plan means has the meaning set out in paragraph 1.2.3 of schedule 5 (Disaster Recovery and Business Continuity);

  • Staff Vetting Procedure means the Authority’s procedures for the vetting of personnel and as advised to the Contractor by the Authority.

  • Resettlement Action Plan or “RAP”, means a plan approved by the Association, to be prepared in accordance with the provisions of the RPF, setting forth principles and procedures governing land acquisition or other associated Project impacts, resettlement and compensation of Affected Persons, as well as reporting and monitoring arrangements to ensure compliance with the said plan, as the same may be amended from time to time with the agreement of the Association, and “Resettlement Action Plans” or “RAPs” shall mean such Resettlement Action Plans, collectively.