Common use of Alternate Claims Processing Clause in Contracts

Alternate Claims Processing. In the event that the Division of TennCare deems Subcontractor and Health Plan unable to timely process and reimburse claims and requires Subcontractor or Health Plan to submit Provider claims for reimbursement to an alternative claims processor to ensure timely reimbursement, Provider shall agree to accept reimbursement at Subcontractor’s contracted reimbursement rate or the rate established by the Division of TennCare, whichever is greater.

Alternate Claims Processing. In the event that the Division Bureau of TennCare deems Subcontractor and Health Plan unable to timely process and reimburse claims and requires Subcontractor or Health Plan to submit Provider claims for reimbursement to an alternative claims processor to ensure timely reimbursement, Provider shall agree to accept reimbursement at Subcontractor’s contracted reimbursement rate or the rate established by the Division Bureau of TennCare, whichever is greater.