The two methods used for coordination of benefits are Cost Avoidance and Post-Payment Recovery.
Post-Payment Recovery means Contractor pays the provider for the services rendered and then uses all reasonable efforts to recover the cost of the services from all liable third parties.
Contractor shall Cost Avoid or make a Post-Payment Recovery for the reasonable value of services paid for by Contractor and rendered to a Member whenever a Member's OHCS covers the same services, either fully or partially.
Cost Avoidance and Post-Payment Recovery of Other Health Coverage Sources (OHCS) 24.
However, in no event shall Contractor Cost Avoid or seek Post-Payment Recovery for the reasonable value of services from a Third- Party Tort Liability (TPTL) action or make a claim against the estates of deceased Members.