Accurate Billing. The Provider agrees to certify by the signature of the Provider or designee, including electronic signatures on a claim form or transmittal document, that the items or services claimed were actually provided and medically necessary, were documented at the time they were provided, were provided in accordance with professionally recognized standards of health care, applicable Department rules, this agreement, and are not billed in excess of the Provider's usual and customary fees. The Provider shall be solely responsible for the accuracy of claims submitted, and shall immediately repay the Department for any items or services the Department, the federal government, duly authorized representatives or the provider determines were not properly provided, documented, or claimed. The Provider must assure it is not submitting a duplicate claim under another program or provider type. The Provider agrees that all original claims for service must be received by the Department within twelve months from the date the service was provided. The Provider agrees that all requests for adjustments of an adjudicated claim must be received by the Department within 12 months of the remittance advice date of the adjudicated claim. The Provider agrees that claims not submitted for payment within these timeframes may not be billed to the client.
Accurate Billing. To certify by the signature of the Provider or designee, including electronic signatures on a claim form or transmittal document, that the items or services claimed were actually provided and medically necessary, were documented at the time they were provided, and were provided in accordance with professionally recognized standards of health care, applicable Department rules and this agreement. The Provider shall be solely responsible for the accuracy of claims submitted, and shall immediately repay the Department for any items or services the Department or the provider determines were not properly provided, documented, or claimed. The provider must assure that they are not submitting a duplicate claim under another program or provider type.
Accurate Billing. Company’s obligation for payment to Provider is independent of any reimbursement received by Company from Clients or third-party payers. Provider (including its employees, contractors and agents) shall not seek compensation from any source (including Clients) other than Company for any Service it provides under this Agreement. The hourly rate will not be adjusted more frequently than annually. Provider agrees to indemnify Company and hold Company harmless for Provider’s inaccurate billing or timekeeping that results in Company’s improper billing or crediting of Clients.
Accurate Billing. The provider agrees that all original Medicaid primary claims must be received by the Department within 180 days from the date the service was provided, all original Medicare crossover claims must be received by the Department within 180 days from the date of the Medicare Explanation of Benefits (EOB), and all original Medicaid secondary/tertiary claims (excludes Medicare crossovers) must be received by the Department within 365 days from the date the service was provided. The provider agrees that all requests for replacements, resubmissions, and voids of an adjudicated claim must be received by the Department within 365 days from the date the service was provided. The provider agrees that claims not submitted for payment within these timeframes may not be billed to the client.
Accurate Billing. To certify by the signature of the Provider or designee, including electronic signatures on a claim form or transmittal document, that the items or services claimed were actually provided and medically necessary, were documented at the time they were provided, and were provided in accordance with professionally recognized standards of health care, applicable Department rules, and this Agreement. The provider further agrees:
Accurate Billing. No Medicaid payment will be made for original claims received by the Department later than one hundred eighty days from the date of service. Final claim adjustments must be submitted within three hundred sixty-five (365) days from the date of service. The Department may grant a variance to extend the deadline for a provider to submit a final claim adjustment. A refusal to grant a variance is not subject to a request for review or an appeal.
