Acceptance of Claims. (1.) PAYOR will not accept claims from PROVIDER for any items or services furnished, ordered or prescribed by excluded individuals or entities. (2.) In the event PROVIDER has not made required disclosures, PAYOR will not be held financially liable to accept PROVIDER claims from excluded individuals or entities. (3.) If payment had been disbursed to PROVIDER prior to PAYOR receiving required disclosures of excluded individuals or entities, PROVIDER shall reimburse PAYOR total actual cost(s) of identified claims.
Appears in 4 contracts
Samples: Medicaid Managed Specialty Supports and Services Agreement, Medicaid Managed Specialty Supports and Services Agreement, Medicaid Managed Specialty Supports and Services Agreement
