Billing Matters. Seller has not submitted any fraudulent or knowingly false bill or claim under any of the Provider Agreements or any other third-party payor program applicable to the Agency. The Agency has implemented policies and procedures and established functioning billing systems that are consistent with industry standards and practices in all material respects to ensure timely preparation and submission of valid and clean claims for reimbursement under the Provider Agreements and all other third-party payor programs in which the Agency participates. Except as disclosed on Schedule 3.1, there have been no Additional Document Requests (ADR) or targeted medical reviews by any State or federal agency, fiscal intermediary or other government contractor during the three (3) years prior to the date of this Agreement and neither the Seller nor the Agency have undergone review or testing under any of the following programs during the three (3) years prior to the date of this Agreement: Comprehensive Error Rate Testing (CERT), Medicare Administrative Contractor (MAC), Medicare Recovery Audit Contractor (RAC), Medicaid Integrity Program audits (MIP) or any similar tests or audits and Seller has not received written notice that any such requests, reviews, testing or audits are pending, and to Seller’s Knowledge, there is no condition or event, which with notice or lapse of time or both, would be likely to result in the initiation of any such requests, reviews, testing or audits. Schedule 3.1 lists all National Provider Identifiers, tax identification and provider numbers utilized in the operation of the Business and the legal entity or individual that holds such identifiers and numbers. Each of Seller's employed physicians and advanced practice professionals providing services at the Business is enrolled to participate in those health insurance programs operated by a governmental authority set forth on Schedule 3.1.
Billing Matters. (a) During the Term, CD Radio shall be responsible for all customer billing and customer service functions in connection
Billing Matters. The parties recognize that many patients, referring clinicians and third party payors require or request the submission of a single claim for the technical and professional component of pathology and laboratory services, which typically are billed under the same CPT code with the appropriate modifier(s). To accommodate such requirements and requests, the parties believe that it is important to submit global claims for Group’s Professional Services and Lab’s technical component services. Therefore, unless otherwise agreed upon by the parties, Group’s Professional Services will be billed on a global basis with Lab’s technical component services. Notwithstanding the foregoing, Group shall have the right to approve the fees to be charged for its Professional Services and all price negotiations with third party payors for its Professional Services.
Billing Matters. We will submit an electronic summary invoice for the professional services described herein after Closing. In the event of a substantial delay in completing the financing, we reserve the right to present an interim statement for payment. Unless other arrangements have been agreed upon in advance, we anticipate our statements to be paid in full within thirty (30) days of receipt. If, for any reason, the financing represented by an issue of Bonds is not consummated or is completed without the delivery of our Bond Opinion or written advice as Disclosure Counsel, or our services are otherwise terminated, we will expect to be compensated at our normal hourly rates, plus client charges, as described above (not to exceed the fee we would have received if we had rendered our Bond Opinion and written advice as Disclosure Counsel). The current hourly rate of the undersigned (as of 1/1/2021) is $275 per hour. Work performed by other attorneys will be billed at their current hourly rate (currently ranging from $200-400 per hour). Work by legal assistants is currently billed at $120 per hour. The hourly rates reflected herein are subject to our periodic review and adjustment – typically annually. We would expect payment from the County, with the County being reimbursed by the Hospital, for any fees under this engagement.
