Billing Guides Sample Clauses

Billing Guides. The following principles must be incorporated into the creation and use of the MCO's billing guides. The MCO must: Collaborate with ODM when developing billing guides to minimize the complexity of conducting business with the State Medicaid agency. Utilize the Provider Master File to adjudicate claims. The MCO must use this information to minimize the impact on provider billing requirements and reduce provider denials and resubmissions. Follow the X12/TR3 industry standard when implementing changes. Follow Council for Affordable Quality Healthcare, Inc. (CAQH) Committee on Operating Rules for Information Exchange (CORE) mandated timeframes with specific claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs) on the 835 transaction of the outcome. The MCO must submit to ODM the same outcome reported to the providers. Participate in any meetings, workgroups, or other activities related to billing guides as directed by XXX. The MCO must notify ODM for review and approval prior to implementation of any changes to billing guide policies or procedures.
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Related to Billing Guides

  • Ordering Guidelines and Processes 1.14.1 For information regarding Ordering Guidelines and Processes for various Network Elements, Combinations and Other Services, TWTC should refer to the “Guides” section of the AT&T Interconnection Web site. TWTC will be notified of any material changes to such “Guides”.

  • BILLING ERRORS In case of errors or questions about electronic funds transfers from your share, savings, checking and money market accounts, or if you need information about a transfer on the statement or receipt telephone us at the following number or send us a written notice to the following address as soon as you can. We must hear from you no later than sixty (60) days after we sent the FIRST statement on which the problem appears. Call us at: (000) 000-0000 in AZ (000) 000-0000 in TX 1 (855) 878-9378 toll free or write to: TruWest Credit Union, Attn: Member Services XX Xxx 0000 Xxxxxxxxxx, XX 00000 • Tell us your name and account number. • Describe the electronic transfer you are unsure about, and explain as clearly as you can why you believe the Credit Union has made an error or why you need more information. • Tell us the dollar amount of the suspected error. If you tell us orally, we may require that you send us your complaint or question in writing within ten (10) business days. We will tell you the results of our investigation within ten (10)* business days after we hear from you and will correct any error promptly. If we need more time, however, we may take up to forty-five (45)** days to investigate your complaint or question. If we decide to do this, we will credit your account within ten (10)* business days for the amount you think is in error, so that you will have the use of the money during the time it takes us to complete our investigation. If we ask you to put your complaint or question in writing and we do not receive it within ten (10) business days, we may not credit your account. We will tell you the results within three (3) business days of completing our investigation. If we decide that there was no error, we will send you a written explanation. You may ask for copies of the documents that we used in our investigation. * If you give notice of an error within thirty (30) days after you make the first deposit to your account, we will have twenty (20) business days instead of ten (10) business days. ** If you give notice of an error within thirty (30) days after you make the first deposit to your account, notice of an error involving a point of sale transaction, or notice of an error involving a transaction initiated outside the U.S. its possessions and territories, we will have ninety (90) days instead of forty-five (45) days to investigate.

  • Overpayment Policies and Procedures Within 90 days after the Effective Date, Xxxxx shall develop and implement written policies and procedures regarding the identification, quantification and repayment of Overpayments received from any Federal health care program.

  • TIMELINESS OF BILLING SUBMISSION The parties agree that timeliness of billing is of the essence to this Contract and recognize that the City is on a fiscal year. All xxxxxxxx for dates of service prior to July 1 must be submitted to the City no later than the first Friday in August of the same year.

  • Billing Specifications 55.6.1 The Parties agree that billing requirements and outputs will be consistent with the Ordering & Billing Form (OBF) and also with Telcordia Technologies Billing Output Specifications (BOS).

  • MASTER CONTRACT SALES REPORTING Contractor shall report total Master Contract sales quarterly to Enterprise Services, as set forth below.

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