Claim Disputes. Provider may, for a period of ninety (90) days from the receipt of payment of a claim, review the payment and provide to INSURER written notice of any perceived underpayment. INSURER shall reimburse Provider the amount of the underpayment within thirty (30) days provided documentation substantiates the payment error. After the ninety (90) day period has expired, payment of that claim is final and may not be disputed for any reason.
Claim Disputes. The result of the Covered Person claim dispute process shall be binding on Provider, per State Medicaid Grievance System requirements. For this Appendix, State Medicaid Grievance System means Arizona Administrative Code Title 9 Chapter 34 et. seq.
Claim Disputes. Should you have a dispute concerning your premium or about a claim, you should contact the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. DISPUTAS POR XXXXXX DE SEGUROS O RECLAMACIONES: Si tiene una disputa relacionada con su prima de seguro o con una reclamación, usted debe comunicarse con la compañía primero. Si la disputa no es resuelta, usted puede comunicarse con el Departamento de Seguros de Texas.
Claim Disputes. The extent of coverage under the group benefit policies referred to in this Article shall be governed by the terms and conditions set forth in said policies and plan documents. Any questions concerning coverage shall be resolved in accordance with the terms and conditions in said policy or plan document and shall not be subject to the grievance procedure set forth in the collective bargaining agreement. However, the Employer agrees to investigate any disputes over benefit plan coverage raised by employees and to assist employees in resolving such disputes with the appropriate insurance carrier or Plan Administrator. In addition, the Employer will aggressively enforce any contracts with insurance carriers or plan administrators to assure that employees get the benefits required under the relevant insurance contracts and/or plan documents.
Claim Disputes. 25 SECTION 6.08 Remedies Exclusive.............................................26 ARTICLE VII
Claim Disputes. Facility may, for a period of 90 (ninety) days from the receipt of payment of a claim, review the payment and provide to INSURER written notice of any perceived underpayment. INSURER will reimburse Facility the amount of the underpayment within 30 (thirty) days provided documentation substantiates the payment error. After the 90 (ninety) day period has expired, payment of that claim is final and may not be disputed for any reason. This Agreement is effective upon the date of execution by USA. For and on behalf of: For and on behalf of: USA MANAGED CARE ORGANIZATION, INC. 000 Xxxxxxx xx Xxxxx Xxxxxxx Xxxxx Xxxxxx, Xxxxx 00000 Date Date Signature Signature Printed Name Printed Name Title Title EXHIBIT A COST CONTAINMENT GUIDELINES
Claim Disputes. Facility may, for a period of 90 (ninety) days from the receipt of payment of a claim, review the payment and provide to INSURER written notice of any perceived underpayment. INSURER will reimburse Facility the amount of the underpayment within 30 (thirty) days provided documentation substantiates the payment error. After the 90 (ninety) day period has expired, payment of that claim is final and may not be disputed for any reason. INSURER may, for a period of 90 (ninety) days from the Facility’s receipt of payment of a claim, provide to Facility written notice of any perceived overpayment. Facility will reimburse INSURER the amount of the overpayment within 30 (thirty) days provided documentation substantiates the payment error. After the 90 (ninety) day period has expired, payment of that claim is final and may not be disputed for any reason. This Agreement is effective upon the date of execution by USA. For and on behalf of: For and on behalf of: USA MANAGED CARE ORGANIZATION, INC. 000 Xxxxxxx xx Xxxxx Xxxxxxx Xxxxx Xxxxxx, Xxxxx 00000 Date Date Signature Signature Printed Name Printed Name Title Title ATTACHMENT I Medicare Supplemental, Advantage, and Employee/Union Group Retiree Plans This is an Attachment to the existing Agreement only, with regard to the subject matter hereof this Attachment hereto shall control, and in no way supersedes the provisions agreed to in the Agreement.
Claim Disputes. Facility may, for a period of 90 (ninety) days from the receipt of payment of a claim, review the payment and provide to INSURER written notice of any perceived underpayment. INSURER will reimburse Facility the amount of the underpayment within 30 (thirty) days provided documentation substantiates the payment error. After the 90 (ninety) day period has expired, payment of that claim is final and may not be disputed for any reason. This Agreement is effective upon the date of execution by USA. For and on behalf of: For and on behalf of: USA MANAGED CARE ORGANIZATION, INC. 000 Xxxxxxx xx Xxxxx Xxxxxxx Xxxxx Xxxxxx, Xxxxx 00000 Date Date Signature Signature Printed Name Printed Name Title Title ATTACHMENT I Medicare Supplemental, Advantage, and Employee/Union Group Retiree Plans This is an Attachment to the existing Agreement only, with regard to the subject matter hereof this Attachment hereto shall control, and in no way supersedes the provisions agreed to in the Agreement.
Claim Disputes. If a Tenant disputes a Claim, including after Claim payment has taken place, then the responsibility for resolving such a dispute will lie solely with Tenant and Company. Obligo will play no role in assessing the correctness or legality of any Claim, nor will it play a role in assessing the merit of Xxxxxx’s reason for dispute. Obligo will not be liable for any damages resulting from incorrect or illegal Claims, nor from unmerited disputes by Tenants. Obligo may, in its sole discretion, communicate with Company and Tenant regarding a Claim or a dispute, but in doing so would not be assuming any responsibility for the resolution of a dispute, nor liability for the outcome of the dispute. If a dispute is resolved in favor of a Tenant, then Company shall be responsible to refund the Claim or portion thereof to or for the account of Tenant.
Claim Disputes. If the Lenders’ Representative delivers a Dispute Notice to Buyer within the Dispute Period, Buyer and the Lenders’ Representative shall promptly meet and use their reasonable efforts to settle the dispute as to whether and to what extent the Buyer Indemnitees are entitled to reimbursement on account of such Buyer Claim. If Buyer and the Lenders’ Representative are able to reach agreement within thirty (30) days after Buyer receives such Dispute Notice, then, if such Buyer Claim shall have been made prior to the Indemnity Escrow Termination Date, Buyer and the Lenders’ Representative shall deliver a joint written instruction to the Escrow Agent setting forth such agreement and instructing the Escrow Agent to pay to Buyer from the Indemnity Escrow Funds an amount in accordance with such agreement, subject to the limitations contained in this Article IX. If Buyer and the Lenders’ Representative are unable to reach agreement within thirty (30) days after Buyer receives such Dispute Notice, then either Buyer, on the one hand, or the Lenders’ Representative on the other hand, may resort to other legal remedies, subject to the limitations set forth in this Article IX.
