Cost Avoidance. As provided in Article 8.13, except in certain cases, the contractor shall attempt to avoid payment in all cases where there is other insurance. The system should have edits to identify potential other coverage situations and flag the claims accordingly. The edits should include looking for accident indicators, other coverage information from the claims, other coverage information on file for the enrollee, and potential accident/injury diagnoses.
Appears in 3 contracts
Sources: Contract to Provide Services (Amerigroup Corp), Contract to Provide Services (Centene Corp), Contract to Provide Services (Americhoice Corp)