Skip to Main Content

Search in HSP

The search's minimum of 4 and maximum of 60 characters. To search for information outside the provider manual or to find a specific provider communication by the assigned material number, use the search bar located at the top right corner of this page.

Please wait while we retrive the findings...

Search Results for:

Displaying 0 of 0 results...

The Plan's Right to Pay Others

Provider Type

  • Physicians
  • Hospitals
  • Participating Physician Groups (PPG)
  • Ancillary

A payment made by another health plan may include an amount that should have been paid by the plan. If this happens, the plan may pay the amount to the organization that made the payment. The amount is then treated as though paid under the member's coverage. The plan does not have to pay that amount again. The term "payment made" includes providing benefits in the form of services, in which case payment made means the reasonable cash value of the benefits provided in the form of services.

Last Updated: 07/01/2024