Common use of Claim Disputes Clause in Contracts

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. i) Provider may wish to file a claim dispute to maintain its regulatory afforded rights, e.g., based on a claim denial; for dissatisfaction with a claim payment; or for recoupment action by United. Provider may challenge the claim denial or adjudication by filing a formal claim dispute with United. Pursuant to AHCCCS guidelines and state rules, all claim disputes challenging claim payments, denials or recoupments must be filed in writing no later than 12 months from the date of services, 12 months after the date of eligibility posting or within 60 days after the payment, denial or recoupment of a timely claim submission, whichever is later. The claim dispute must be referenced/titled as such, i.e., “claim dispute” and state with particularity the factual and legal basis for the relief requested, along with all supporting documentation such as claims, remits, medical review sheets, medical records, correspondence, etc. Incomplete submissions or those which do not meet the criteria for a claim dispute will be denied. ii) If Provider disagrees with the claim dispute decision at issue, Provider may submit its written request for a state fair hearing within 30 days of receipt of Provider’s claim dispute notice of decision (claim dispute at issue). Provider’s request for state fair hearing must include the claim dispute number from the notice of decision, the Covered Person’s name, and be clearly identified as a request for state fair hearing. iii) All claim disputes must be submitted in writing in accordance with address listed on Provider’s remit from United and in applicable provider manual/administrative guide.

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. i) Provider may wish to file a claim dispute to maintain its regulatory afforded rights, e.g., based on a claim denial; for dissatisfaction with a claim payment; or for recoupment action by United. Provider may challenge the claim denial or adjudication by filing a formal claim dispute with United. Pursuant to AHCCCS DCS guidelines and state rulesDepartments’ Rules, all claim disputes challenging claim payments, denials or recoupments must be filed in writing no later than 12 months from the date of services, 12 months after the date of eligibility posting or within 60 days after the payment, denial or recoupment of a timely claim submission, whichever is later. The claim dispute must be referenced/titled as such, i.e., “claim dispute” and state with particularity the factual and legal basis for the relief requested, along with all supporting documentation such as claims, remits, medical review sheets, medical records, correspondence, etc. Incomplete submissions or those which do not meet the criteria for a claim dispute will be denied. ii) If Provider disagrees with the claim dispute decision at issue, Provider may submit its written request for a state fair hearing within 30 days of receipt of Provider’s claim dispute notice of decision (claim dispute at issue). Provider’s request for state fair hearing must include the claim dispute number from the notice of decision, the Covered Person’s name, and be clearly identified as a request for state fair hearing. iii) All claim disputes must be submitted in writing in accordance with address listed on Provider’s remit from United and in applicable provider manual/administrative guide.

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. i) Provider may wish to file a claim dispute to maintain its regulatory afforded rights, e.g., based on a claim denial; for dissatisfaction with a claim payment; or for recoupment action by UnitedHealth Plan and/or Subcontractor. Provider may challenge the claim denial or adjudication by filing a formal claim dispute with UnitedHealth Plan and/or Subcontractor. Pursuant to AHCCCS guidelines and state rules, all claim disputes challenging claim payments, denials or recoupments must be filed in writing no later than 12 months from the date of services, 12 months after the date of eligibility posting or within 60 days after the payment, denial or recoupment of a timely claim submission, whichever is later. The claim dispute must be referenced/titled as such, i.e., “claim dispute” and state with particularity the factual and legal basis for the relief requested, along with all supporting documentation such as claims, remits, medical review sheets, medical records, correspondence, etc. Incomplete submissions or those which do not meet the criteria for a claim dispute will be denied. ii) If Provider disagrees with the claim dispute decision at issue, Provider may submit its written request for a state fair hearing within 30 days of receipt of Provider’s claim dispute notice of decision (claim dispute at issue). Provider’s request for state fair hearing must include the claim dispute number from the notice of decision, the Covered Person’s name, and be clearly identified as a request for state fair hearing. iii) All claim disputes must be submitted in writing in accordance with address listed on Provider’s remit from United Health Plan and/or Subcontractor and in applicable provider manual/administrative guide.

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. i(a) Provider may wish to file a claim dispute to maintain its regulatory afforded rights, e.g., based on a claim denial; for dissatisfaction with a claim payment; or for recoupment action by UnitedHealth Plan and/or Subcontractor. Provider may challenge the claim denial or adjudication by filing a formal claim dispute with UnitedHealth Plan and/or Subcontractor. Pursuant to AHCCCS guidelines and state rules, all claim disputes challenging claim payments, denials or recoupments must be filed in writing no later than 12 months from the date of services, 12 months after the date of eligibility posting or within 60 days after the payment, denial or recoupment of a timely claim submission, whichever is later. The claim dispute must be referenced/titled as such, i.e., “claim dispute” and state with particularity the factual and legal basis for the relief requested, along with all supporting documentation such as claims, remits, medical review sheets, medical records, correspondence, etc. Incomplete submissions or those which do not meet the criteria for a claim dispute will be denied. ii(b) If Provider disagrees with the claim dispute decision at issue, Provider may submit its written request for a state fair hearing within 30 days of receipt of Provider’s claim dispute notice of decision (claim dispute at issue). Provider’s request for state fair hearing must include the claim dispute number from the notice of decision, the Covered Person’s name, and be clearly identified as a request for state fair hearing. iii(c) All claim disputes must be submitted in writing in accordance with address listed on Provider’s remit from United Health Plan and/or Subcontractor and in applicable provider manual/administrative guide.

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. i) i. Provider may wish to file a claim dispute to maintain its regulatory afforded rights, e.g., based on a claim denial; for dissatisfaction with a claim payment; or for recoupment action by United. Provider may challenge the claim denial or adjudication by filing a formal claim dispute with United. Pursuant to AHCCCS guidelines and state rules, all claim disputes challenging claim payments, denials or recoupments must be filed in writing no later than 12 months from the date of services, 12 months after the date of eligibility posting or within 60 days after the payment, denial or recoupment of a timely claim submission, whichever is later. The claim dispute must be referenced/titled as such, i.e., “claim dispute” and state with particularity the factual and legal basis for the relief requested, along with all supporting documentation such as claims, remits, medical review sheets, medical records, correspondence, etc. Incomplete submissions or those which do not meet the criteria for a claim dispute will be denied. ii) . If Provider disagrees with the claim dispute decision at issue, Provider may submit its written request for a state fair hearing within 30 days of receipt of Provider’s claim dispute notice of decision (claim dispute at issue). Provider’s request for state fair hearing must include the claim dispute number from the notice of decision, the Covered Person’s name, and be clearly identified as a request for state fair hearing. iii) . All claim disputes must be submitted in writing in accordance with address listed on Provider’s remit from United and in applicable provider manual/administrative guide.

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. (i) Provider may wish to file a claim dispute to maintain its regulatory afforded rights, e.g., based on a claim denial; for dissatisfaction with a claim payment; or for recoupment action by UnitedHealth Plan and/or Subcontractor. Provider may challenge the claim denial or adjudication by filing a formal claim dispute with UnitedHealth Plan and/or Subcontractor. Pursuant to AHCCCS ADES/DDD guidelines and state Departments’ rules, all claim disputes challenging claim payments, denials or recoupments must be filed in writing no later than 12 months from the date of services, 12 months after the date of eligibility posting or within 60 days after the payment, denial or recoupment of a timely claim submission, whichever is later. The claim dispute must be referenced/titled as such, i.e., “claim dispute” and state with particularity the factual and legal basis for the relief requested, along with all supporting documentation such as claims, remits, medical review sheets, medical records, correspondence, etc. Incomplete submissions or those which do not meet the criteria for a claim dispute will be denied. (ii) If Provider disagrees with the claim dispute decision at issue, Provider may submit its written request for a state fair hearing within 30 days of receipt of Provider’s claim dispute notice of decision (claim dispute at issue). Provider’s request for state fair hearing must include the claim dispute number from the notice of decision, the Covered Person’s name, and be clearly identified as a request for state fair hearing. (iii) All claim disputes must be submitted in writing in accordance with address listed on Provider’s remit from United Health Plan and/or Subcontractor and in applicable provider manual/administrative guide.

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. i) Provider may wish to file a claim dispute to maintain its regulatory afforded rights, e.g., based on a claim denial; for dissatisfaction with a claim payment; or for recoupment action by United. Provider may challenge the claim denial or adjudication by filing a formal claim dispute with United. Pursuant to AHCCCS ADES/DDD guidelines and state rulesDepartments’ Rules, all claim disputes challenging claim payments, denials or recoupments must be filed in writing no later than 12 months from the date of services, 12 months after the date of eligibility posting or within 60 days after the payment, denial or recoupment of a timely claim submission, whichever is later. The claim dispute must be referenced/titled as such, i.e., “claim dispute” and state with particularity the factual and legal basis for the relief requested, along with all supporting documentation such as claims, remits, medical review sheets, medical records, correspondence, etc. Incomplete submissions or those which do not meet the criteria for a claim dispute will be denied. ii) If Provider disagrees with the claim dispute decision at issue, Provider may submit its written request for a state fair hearing within 30 days of receipt of Provider’s claim dispute notice of decision (claim dispute at issue). Provider’s request for state fair hearing must include the claim dispute number from the notice of decision, the Covered Person’s name, and be clearly identified as a request for state fair hearing. iii) All claim disputes must be submitted in writing in accordance with address listed on Provider’s remit from United and in applicable provider manual/administrative guide.

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. (i) Provider may wish to file a claim dispute to maintain its regulatory afforded rights, e.g., based on a claim denial; for dissatisfaction with a claim payment; or for recoupment action by UnitedHealth Plan and/or Subcontractor. Provider may challenge the claim denial or adjudication by filing a formal claim dispute with UnitedHealth Plan and/or Subcontractor. Pursuant to AHCCCS guidelines and state rules, all claim disputes challenging claim payments, denials or recoupments must be filed in writing no later than 12 months from the date of services, 12 months after the date of eligibility posting or within 60 days after the payment, denial or recoupment of a timely claim submission, whichever is later. The claim dispute must be referenced/titled as such, i.e., “claim dispute” and state with particularity the factual and legal basis for the relief requested, along with all supporting documentation such as claims, remits, medical review sheets, medical records, correspondence, etc. Incomplete submissions or those which do not meet the criteria for a claim dispute will be denied. (ii) If Provider disagrees with the claim dispute decision at issue, Provider may submit its written request for a state fair hearing within 30 days of receipt of Provider’s claim dispute notice of decision (claim dispute at issue). Provider’s request for state fair hearing must include the claim dispute number from the notice of decision, the Covered Person’s name, and be clearly identified as a request for state fair hearing. (iii) All claim disputes must be submitted in writing in accordance with address listed on Provider’s remit from United Health Plan and/or Subcontractor and in applicable provider manual/administrative guide.