Claim Adjustments Sample Clauses

Claim Adjustments. PHARMACY shall electronically adjust all credits, duplicate claims, returned, and unclaimed prescriptions within ten
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Claim Adjustments. PHARMACY shall electronically adjust all credits, duplicate claims, returned, and unclaimed prescriptions within ten (10) business days after the original fill date. This includes, but is not limited to, reversals, and re-submittals for “return to stock” or partial fills, where the Covered Medication is partially filled and the remainder is not retrieved by the Member in a reasonable period of time, in which case PHARMACY must electronically reverse and resubmit the actual quantity of the Covered Medication received by the Member.
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Claim Adjustments. Each Party shall inform the other within sixty (60) days after discovery of any Overpayment or any underpayment and both parties shall take prompt and effective measures to remedy such Overpayment or underpayment. A Party may recover an Overpayment or underpayment in accordance with this Agreement, Policies and Procedures and Law. If CareSource determines that an Overpayment has been made to Provider, CareSource will notify Provider of such Overpayment and the Provider shall refund any amounts due within thirty (30) days. If Provider does not remit payment to CareSource within thirty (30) days, CareSource may off-set such payment against future Claim payments owed to Provider by CareSource to the extent permitted by applicable Law. If Provider disagrees with any determination by CareSource that Provider has received an Overpayment, Provider shall have the right to appeal such determination as provided in Policies and Procedures; however, such appeal shall not suspend CareSource’s right to recover the Overpayment during the appeals process, unless otherwise prohibited by Law.
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Claim Adjustments. TPA shall perform all adjustments, refunding and payment of prescribed bonuses, if any, to Participating Provider physicians on a quarterly basis; provided, however, that no such adjustments shall be made or bonuses paid from Patient's Choice Regional IPA distribution pools for the first 12 months during which the Plan is operative. In connection with such quarterly adjustments and payments, TPA shall provide to Patient's Choice and each Regional IPA a profile of Participating Providers utilization relative to other Participating Providers within a Regional IPA and of each Regional IPAs utilization relative to the other Regional IPAs.
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Related to Claim Adjustments

  • True-Up Adjustments From time to time, until the Retirement of the Recovery Bonds, the Servicer shall identify the need for True-Up Adjustments and shall take all reasonable action to obtain and implement such True-Up Adjustments, all in accordance with the following:

  • Tax Adjustments The Company may make such reductions in the Purchase Price, in addition to those required by Sections 3, 4, 5, 6, 7 and 8, as the Board of Directors considers to be advisable to avoid or diminish any income tax to holders of Common Stock or rights to purchase Common Stock resulting from any dividend or distribution of stock (or rights to acquire stock) or from any event treated as such for income tax purposes.

  • Closing Adjustments Adjustments to the Purchase Price shall be made between Seller and Purchaser and shall be prorated on a per diem basis as of the Closing Date. The Closing Date shall be a day of income and expense for Purchaser. The following items shall be prorated and adjusted between Seller and Purchaser as of the Closing Date, except as otherwise specified: 9.1 Prepaid rents and other prepaid charges collected by Seller from Tenant for the month of Closing shall be prorated by credit to Purchaser. Rents and other charges which relate to periods prior to Closing which have not been collected as of Closing (collectively "Delinquent Rents") shall not be prorated. Seller shall have the right to collect Delinquent Rents from Tenant, which may include legal proceedings against Tenant as Seller deems appropriate, provided no such action shall demand possession or termination of the Lease. Any rents collected after closing shall be applied against the receivable as indicated by Tenant, provided if not specifically identifiable, rents collected after Closing from Tenant shall be applied: (i) first, rents due for the month in which such payment is received, (iii) second, to rents attributable to any period after Closing which are past due on the date of receipt, and (iv) third, to Delinquent Rents. After Closing, Seller shall promptly remit to Purchaser any rents received relating to periods after Closing and Purchaser shall promptly remit to Seller any Delinquent Rents received. The provision of this Section 9.1 shall survive Closing. 9.2 Real estate taxes, water, electricity, sewer, gas, telephone and other utilities and charges which are paid directly by Tenant under the Lease shall not be prorated. 9.3 To the extent that errors are discovered in, or additional information becomes available with respect to, the prorations and allocations made at Closing, Seller and Purchaser agree to make such post-Closing adjustments as may be necessary to correct any inaccuracy; however, all prorations (except for prorations and allocations of (i) ad valorem taxes, (ii) tenant reimbursables of taxes and operating expenses, as applicable and (iii) prorations or allocations that are then currently in dispute) shall be final no later than six (6) months after Closing.

  • Cost Adjustments Both parties agree that contracted prices shall be fixed for the first 12 months of this Contract. Contractor must submit to District any proposed cost adjustments at least 60 days before the proposed effective date of such increases with a detailed explanation for each adjustment. District alone reserves the right to reject any changes to this Contract it deems unacceptable.

  • CPI Adjustment If the CPI Percentage Increase (as defined below) is more than [***] for the relevant Adjustment Period, then the Rent payable during that Adjustment Period shall be adjusted upward by a percentage equal to the CPI Percentage Increase (as defined below) applicable to such Adjustment Period, but not to exceed an adjustment during any Adjustment Period of greater than [***]. The term “Consumer Price Index” shall mean the unadjusted Consumer Price Index for All Urban Workers, U.S. City Average, All Items, 1982-84=100, calculated and published by the United States Department of Labor, Bureau of Labor Statistics. The “CPI Percentage Increase” shall mean, with respect to any Adjustment Period, [***]. For the avoidance of doubt, no CPI Adjustment shall be made to any payment due under this Ground Lease for any Adjustment Period if the result of such CPI Adjustment would be to (a) reduce the amount of such payment to an amount that is less than the amount of such payment due for the immediately preceding Adjustment Period or (b) to raise the amount of such payment to an amount that is greater than [***]. For illustrative purposes only, [***]. The CPI Percentage Increase for any Adjustment Period shall be calculated by the Tenant, and the Tenant shall deliver written notice to the Landlord describing such calculation in reasonable detail (a “CPI Notice”) no later than thirty (30) days after the commencement of any Adjustment Period. If the Landlord disagrees with the Tenant’s calculation of the CPI Percentage Increase, then the Landlord shall deliver to the Tenant written notice, describing the basis for such disagreement in reasonable detail (a “CPI Disagreement Notice”), not later than thirty (30) days after delivery of the CPI Notice. If the Landlord fails to deliver a CPI Disagreement Notice within thirty (30) days after delivery of any CPI Notice, then the Landlord shall be conclusively deemed to have agreed with the calculation of the CPI Percentage Increase set forth in such CPI Notice.