Billing and Collections. Except for members exempt from cost sharing pursuant to Section 4.1.4, all HIP members are responsible for making financial contributions to their health care coverage, either through regular POWER Account contributions or HIP Basic copayments for services. The Contractor shall be responsible for billing, collecting and applying applicable POWER Account contributions for members receiving HIP Plus or HIP State Plan Plus benefits. Collection services shall include: Creating and maintaining HIPAA compliant POWER Account contribution billing services; Generating and mailing invoices, although members may opt-in to receiving electronic invoices; Receiving and posting payments; Monitoring and tracking missed payments; Processing returned checks; Stopping or placing collections on hold as directed by the State; Generating past due notices and other notifications; Generating other informational materials as requested by the State; Providing documentation of account activities and other financial reports; Processing and mailing fast track prepayment and/or POWER Account contribution refunds; Transferring collected funds as requested by the State; Documentation and reconciliation of funds received and transferred; Establishing and handling a lockbox for HIP payments; Providing services online that support and interface with the State’s current website; Ensuring the integrity and accuracy of data exchanged with or provided to the State, and that the data is compatible with other software, hardware or systems used by the State; Ensuring compliance with current bankruptcy rules, the Cash Management Improvement Act of 1990 guidelines (Public Law 101-453), confidential information and electronic transaction processing procedures; Adhering to established health care industry standards, in addition to any Medicaid rules, regulations and or mandates, as well as amendments thereto; Date stamping mail received; and Forwarding all change of address notifications and mail returned as undeliverable as specified by the State. Additionally, while the Contractor is not required to promote cash payment by mail as a payment option, the Contractor shall be equipped to accept cash payments, including cash payment by mail, if submitted by the member. Further, the State encourages arrangements with local entities to facilitate the collection of contributions, including no-cost options for collecting cash contributions. In addition, the State will as...
Billing and Collections. The Contractor shall develop and mail invoices for HIP members that include the following information: The name of the Contractor; First name, last name and address of payor; First names of members; Current monthly POWER Account contribution owed; Tobacco surcharge owed; POWER Account contribution past due; Overpayment shown as credit; Payor MID of the person responsible for payment; Consequences of not paying the POWER Account contribution; Notice to send payment in all accepted forms, such as check, money order, on-line payment, unlimited electronic check or debit card via telephone, payroll deduction, automatic draft withdrawal from a designated account, cash payments or automated clearinghouse (ACH), including instructions on how to perform the transaction; How to notify the Contractor of an address change; How to report any change in household or household income; How to notify the Contractor when individuals or families have billing questions or concerns; How to contact the enrollment broker if the individual desires to change MCEs for just cause; Legal statement regarding bankruptcy, if applicable; and Any additional information as directed by FSSA. Regardless of whether the Contractor subcontracts the billing and collections function to another entity, invoices and any other related billing and collections materials shall be sent under the Contractor’s name, not the name of the subcontractor. The Contractor shall translate invoices into Spanish, as well as any other languages that are spoken by at least three percent (3%) of the general population in the Contractor's service area as determined by annual report from translation line requests or are requested by OMPP. Currently, the State notifies the Contractor of Spanish- speaking members only. At a minimum, the invoice mailing shall include an invoice with a detachable payment coupon and a return envelope. As of June 1, 2020 the return envelope shall include pre- paid postage. Occasional one-page inserts may be required by OMPP to explain programmatic or billing changes. The Contractor shall provide members the option to sign-up and receive invoices via e-mail. The Contractor shall xxxx for, and collect, POWER Account contributions and tobacco surcharge payments on a monthly basis. Partial monthly payments may be accepted by the Contractor; however, the member shall pay the monthly payment in full within sixty (60) days from the first day of the coverage month for w...
Billing and Collections. Effective on the respective dates on which the novation of any Reinsured Policy is effective, the Reinsurer shall have sole responsibility for billing and collecting policy loan repayments, interest and the making of payments of dividends in respect of the Novated Policies, subject to the terms of any administrative or other agreements between the parties hereto that have been or heretofore may be entered into and the terms of agreements between the Reinsurer and its agents or subcontractors.
Billing and Collections. ProMedCo-Temple shall bxxx patients and collect all fees for services performed inside or outside the Clinic Facility or arrange for such billing and collection. KDCP hereby appoints ProMedCo-Temple, for the term hereof, to be its true and lawful attorney-in-fact for the following purposes (i) to bxxx patients in KDCP's name and on its behalf, (ii) to collect accounts receivable resulting from such billing in KDCP's name and on its behalf, (iii) to receive payments from Blue Cross and Blue Shield, Medicare, Medicaid, payments from health plans, and all other third party payors; (iv) to receive the cash proceeds of any accounts receivable; (v) to take possession of and endorse in the name of KDCP (and/or in the name of an individual physician, such payment intended for purpose of payment of a physician's bxxx) any notes, checks, money orders, insurance payments and other instruments received in payment of accounts receivable; and (vi) in accordance with policies adopted by the Policy Council, to initiate legal proceedings in the name of KDCP to collect any accounts and monies owed to the Clinic, to enforce the rights of KDCP as creditors under any contract or in connection with the rendering of any service, and to contest adjustments and denials by governmental agencies (or its fiscal intermediaries) as third-party payors. All adjustments made for uncollectible accounts, professional courtesies and other activities that do not generate a collectible fee shall be done in a reasonable and consistent manner acceptable to ProMedCo-Temple's independent certified public accountants.
Billing and Collections. (a) Subject to the provisions of Section 3.6(b) below, Manager shall, on behalf of Practice, bill xxx collect from third party payors, intermediaries and patients all professional fees for medical services and for ancillary services performed at the Medical Offices by Practice and Practice's employees and agents, including, but not limited to, Physician Partners and Practice Employees, provided that Practice shall establish the fee schedule for all physician and ancillary services and pharmaceutical and other (e.g., hearing aids) items provided by Practice. Manager shall use reasonable diligence in its efforts to collect professional fees consistent with industry practice. At its sole cost and expense, the Practice shall have the right to periodically review such billing procedures, and in accordance with the policies approved by the Advisory Board, Manager will use reasonable judgment to settle and discount fees in consultation with the Advisory Board. For the term of this Agreement, Practice hereby grants Manager power of attorney and appoints Manager as its true and lawful attorney-in-fact for the following purposes:
(i) To bill xxxrd party payors, fiscal intermediaries and patients in Practice's name, under its provider number(s) when obtained and on its behalf, and until such time as Practice has obtained its provider number(s), bill, xx the Physician Partners' and Practice Employees' names under their respective provider numbers and on their behalf, and in connection with such billing services Manager covenants and agrees that it will use its best efforts to perform the billing correctly and in accordance with applicable laws and regulations based on information that Practice and the Physician Partners and Practice Employees provide to Manager for such purpose;
(ii) To collect accounts receivable and claims for reimbursement that are generated by such billxxxx xx Practice's name and on Practice's behalf, and in the name and on behalf of all Physician Partners and Practice Employees;
(iii) To place such accounts for collection, settle and compromise claims, and institute legal action for the recovery of accounts in accordance with policies adopted by the Advisory Board;
(iv) Following receipt by Practice, to take possession of payments from patients, insurance companies, Medicare, Medicaid and all other payors with respect to services rendered by Practice, Physician Partners and Practice Employees, and Practice hereby covenants to forward such payment...
Billing and Collections. (a) Manager shall engage Financial Services of Southwest Florida, a Florida limited liability company (“FSS”) to provide billing and collection services on behalf of Medical Group pursuant to that certain Billing Services Agreement between Manager and FSS (the “Billing Services Agreement”).
(b) All Net Collected Dollars of Medical Group shall be deposited in a lockbox bank account in the name of Medical Group (the “Account”) with a bank (“Bank”) mutually agreed upon by the parties until termination or expiration of this Agreement. Manager shall remain a required signatory on the Account and shall be authorized to make payments from such account on behalf of the Medical Group, including without limitation, the Management Fee. Medical Group shall cause FSS to instruct all third party payors to deposit their payments directly into the Account. Medical Group shall provide the Bank standing instructions that at the end of each day all of the funds in the Account shall be swept into another account maintained by Manager at the Bank or by wire transfer to appropriate account(s) of Manager. Such letter of instruction shall not be altered, modified, changed or supplemented by the Medical Group absent Manager’s prior written agreement. Any such alteration, modification or change may be deemed by Manager as an event of default by the Medical Group under the terms of this Agreement. To the extent that any Net Collected Dollars are not sent directly to the Account as required by this Agreement, or are received by Medical Group, such collection shall be immediately remitted, in the form received, to the Account immediately upon receipt by Medical Group. This Section 5(b) shall expressly survive any termination or expiration of this Agreement.
(c) The parties acknowledge that all collections of Medical Group shall be applied first to the expenses and obligations of Medical Group (excluding any amounts due and owing to Manager or FSS) as stated in Medical Group’s annual budget (which budget shall be subject to the approval of Manager), and then applied to any amounts due and owing to Manager hereunder or due FSS pursuant to the Billing Services Agreement, until such amounts are paid in full. On or before the 15th day after each month, Manager shall remit the remaining balance in the Account to Medical Group.
(d) So long as any Management Fee or Billing Services Fee or any other liabilities or obligations of the Medical Group under this Agreement remain unpaid, Manager sha...
Billing and Collections. Premier shall provide billing and collection services for all professional services rendered at the Center, all such billing and collections to be done in the name of and subject to the control of the Orthodontic Entity.
Billing and Collections. In order to relieve HLM of the administrative burden of handling the billing and collection of sums due under Architectural and Engineering Agreements, Design shall be responsible, on behalf of and for HLM, for billing and collecting the charges made with respect to Architectural and Engineering Agreements and any or all other services provided at the Offices; provided that responsibility for specific accounts may be retained by HLM at the mutual agreement of HLM and Design. In such event HLM agrees that it will keep and provide to Design all invoices, documents, evidence and records necessary for the purpose of supporting the fees charged for all architectural and engineering services from time to time. It is expressly understood that the extent to which Design will endeavor to collect such charges, the methods of collecting, the settling of disputes with respect to charges, and the writing off of charges that may be or appear to be uncollectible shall at all times be within the sole discretion of Design (but subject to all applicable governmental regulations and the terms and conditions of applicable agreements), and that Design does not guarantee the extent to which any charges billed will be collected. At HLM's request, Design will reassign to HLM for collection by HLM, any accounts which Design has determined to be uncollectible.
Billing and Collections. To xxxx and receive (“Receipts”) all revenue earned by and due to City, in connection with City’s provision of inspection and/or permit services provided/rendered at business locations throughout the City’s service area, and to receive all Receipts on City’s behalf and to xxx for and give satisfaction for monies due on account and to withdraw any claims, suits, or proceedings pertaining to or arising out of Company’s or City’s right to collect such amounts; and
Billing and Collections. Medical Group shall engage Financial Services of Southwest Florida, a Florida limited liability company to provide billing and collection services on behalf of Medical Group pursuant to that a Billing Services Agreement (the “Billing Services Agreement”).