Common use of Cost Avoidance Activities Clause in Contracts

Cost Avoidance Activities. a. The Contractor shall be responsible for cost avoidance through the Coordination of Benefits (COB) for public and private resources, including but not limited to Medicare, private health insurance, Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§ 1001, et. seq., plans, and workers' compensation. The Contractor must attempt to avoid initial payment of Claims, whenever possible, where public or private resources are available. All cost• avoided funds must be reported to the Department on a form approved by the Department, showing that TPL has been pursued and the amount which has been cost- avoided. The Contractor shall not be held responsible for any TPL errors in the Department's Eligibility Verification System (EVS) or the Department's TPL file. b. The Contractor may not deny or delay approval of otherwise covered treatment or services based upon TPL considerations. The Contractor may neither unreasonably delay payment nor deny payment of claims unless it has established the probable existence of TPL at the time the claim is adjudicated.

Cost Avoidance Activities. a. The Contractor shall be responsible for cost avoidance through the Coordination of Benefits (COB) for public and private resources, including but not limited to Medicare, private health insurance, Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§ 1001, et. seq., plans, and workers' compensation. The Contractor must attempt to avoid initial payment of Claims, whenever possible, where public or private resources are available. All cost• cost- avoided funds must be reported to the Department on a form approved by the Department, showing that TPL has been pursued and the amount which has been cost- avoided. The Contractor shall not be held responsible for any TPL errors in the Department's Eligibility Verification System (EVS) or the Department's TPL file. b. The Contractor may not deny or delay approval of otherwise covered treatment or services based upon TPL considerations. The Contractor may neither unreasonably delay payment nor deny payment of claims unless it has established the probable existence of TPL at the time the claim is adjudicated.

Cost Avoidance Activities. a. The Contractor shall be responsible for cost avoidance through the Coordination of Benefits (COB) for public and private resources, including but not limited to Medicare, private health insurance, Employee Employees Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§ 1001, et. seq., plans, and workers' compensation. The Contractor must attempt to avoid initial payment of Claims, whenever possible, where public or private resources are available. All cost• cost- avoided funds must be reported to the Department on a form approved by the Department, showing that TPL has been pursued and the amount which has been cost- avoided. The Contractor shall not be held responsible for any TPL errors in the Department's Eligibility Verification System (EVS) or the Department's TPL file. b. The Contractor may not deny or delay approval of otherwise covered treatment or services based upon TPL considerations. The Contractor may neither unreasonably delay payment nor deny payment of claims unless it has established the probable existence of TPL at the time the claim Claim is adjudicated.

Cost Avoidance Activities. a. The Contractor shall be responsible for cost avoidance through the Coordination of Benefits (COB) for public and private resources, including but not limited to Medicare, private health insurance, Employee Employees Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§ 1001, et. seq., plans, and workers' compensation. The Contractor must attempt to avoid initial payment of Claims, whenever possible, where public or private resources are available. All cost• cost- avoided funds must be reported to the Department on a form approved by the Department, showing that TPL has been pursued and the amount which has been cost- cost-avoided. The Contractor shall not be held responsible for any TPL errors in the Department's Eligibility Verification System (EVS) or the Department's TPL file. b. The Contractor may not deny or delay approval of otherwise covered treatment or services based upon TPL considerations. The Contractor may neither unreasonably delay payment nor deny payment of claims unless it has established the probable existence of TPL at the time the claim Claim is adjudicated.

Cost Avoidance Activities. a. The Contractor shall be responsible for cost avoidance through the Coordination of Benefits (COB) for public and private resources, including but not limited to Medicare, private health insurance, Employee Employees Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§ 1001, et. seq., plans, and workers' compensation. The Contractor must attempt to avoid initial payment of Claims, whenever possible, where public or private resources are available. All cost• cost- avoided funds must be reported to the Department on a form approved by the Department, showing that TPL has been pursued and the amount which has been cost- cost-avoided. The Contractor shall not be held responsible for any TPL errors in the Department's Eligibility Verification System (EVS) or the Department's TPL file. b. The Contractor may not deny or delay approval of otherwise covered treatment or services based upon TPL considerations. The Contractor may neither unreasonably delay payment nor deny payment of claims unless it has established the probable existence of TPL at the time the claim Claim is adjudicated.

Cost Avoidance Activities. a. The Contractor shall be responsible for cost avoidance through the Coordination of Benefits (COB) for public and private resources, including but not limited to Medicare, private health insurance, Employee Employees Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. §§ 1001, et. seq., plans, and workers' compensation. The Contractor must attempt to avoid initial payment of Claims, whenever possible, where public or private resources are available. All cost• avoided funds must be reported to the Department on a form approved by the Department, showing that TPL has been pursued and the amount which has been cost- cost-avoided. The Contractor shall not be held responsible for any TPL errors in the Department's Eligibility Verification System (EVS) or the Department's TPL file. b. The Contractor may not deny or delay approval of otherwise covered treatment or services based upon TPL considerations. The Contractor may neither unreasonably delay payment nor deny payment of claims unless it has established the probable existence of TPL at the time the claim Claim is adjudicated.