Claim Reimbursement Sample Clauses

Claim Reimbursement. COUNTY shall reimburse PROVIDER based on COUNTY’s established reimbursement rate(s) as reflected on the Financial Summary(ies) and Specialty Mental Health Services Medi- Cal Reimbursement Rate Table, less all other revenue, interest and return collected by PROVIDER from services/activities delivered under this Agreement, as described in Paragraph 4 (FINANCIAL PROVISIONS), for the DHCS approved specialty mental health services. Reimbursement shall be based upon specialty mental health services actually provided as shown on COUNTY's data systems reports, PROVIDER’s claim, and DHCS acceptance, approval, and payment of COUNTY’s correlating claim submission. PROVIDER certifies that all units of service claimed by PROVIDER are true and accurate claims for reimbursement. COUNTY shall make payment to PROVIDER upon adjudication and payment by DHCS to COUNTY. Under extreme or extenuating circumstances, PROVIDER may request a provisional reimbursement to be made prior to COUNTY’s receipt of payment by DHCS, based upon specialty mental health services actually provided as shown on COUNTY’s data system reports. Such provisional payments are at Director’s sole discretion, and shall be reviewed and determined by Director on a case by case basis. i. Final reimbursement to PROVIDER shall be based upon DHCS approved units of service at COUNTY’s reimbursement rates as listed in Financial Summary and Exhibit A – Medi-Cal Reimbursement Rate Table. ii. Further, PROVIDER agrees to hold harmless both the State and member in the event COUNTY cannot or shall not pay for services performed by PROVIDER pursuant to this Agreement. iii. PROVIDER shall submit a claim for services rendered via this Agreement within forty-five (45) days of Agreement termination date. COUNTY shall not pay claims received after forty-five (45) days of Agreement termination date unless claims are approved by COUNTY’s Department of Behavioral Health Director or Director’s designee.

Claim Reimbursement. Public Infrastructure. The right to demand repair or replacement of failed Public Infrastructure/System Improvements or for reimbursement from the Developer for costs of remedying a particular failure or default relating to the Public Infrastructure/System Improvements, in excess of any security posted or provided during the warranty period, or prior thereto.

Claim Reimbursement. ▇▇▇▇▇▇’▇ sole liability for freight damage or loss shall be to reimburse SmartDisk for those amounts stated in Section 4.2 above that are actually paid by the carrier.

Claim Reimbursement. If the settlement is finally approved, including resolving any appeals in favor of upholding the settlement, you can ask to be reimbursed if you previously paid for frame replacement for rust perforation that satisfies the Rust Perforation Standard on a Subject Vehicle and were not otherwise reimbursed. To be eligible for reimbursement, you must submit a Claim Form and the expenses must have been incurred prior to [date of the Initial Notice Date]. The Claim Form is attached to this Notice and is also available on the settlement website [website]. In no event shall a Class Member be entitled to more than one Case 2:15-cv-02171-FMO-FFM Document 91-1 Filed 11/15/16 Page 36 of 122 Page ID #:1565 payment per Subject Vehicle. You must submit your Claim Form and any supporting documentation, if available, for prior frame replacement to the Settlement Notice Administrator. The deadline to submit Claim Forms is sixty (60) days after the Court issues the Final Order and Final Judgment, which will occur, if approved, after the Fairness Hearing. The Settlement Claims Administrator will determine whether Claim Forms are complete and timely. If your Claim is deficient, the Settlement Claims Administrator will mail you a letter requesting that you complete the deficiencies and resubmit the Claim Form within forty-five (45) days. If you fail to provide the requested documentation or information, your Claim will be denied. The Settlement Claims Administrator will review your Claim Form and other Claims that are submitted and determine if reimbursement is owed. Review of Claims should be completed within ninety (90) days of receipt, but this review period is not required to begin any earlier than sixty (60) days after the settlement is finally approved and all appeals, if any, are resolved in favor of upholding the settlement. If your Claim is rejected for payment, the Settlement Claims Administrator will notify Toyota and Class Counsel of the rejection of the Claim and the reason(s) why. Class Counsel will review the rejected Claim and may consult with Toyota in an attempt to resolve these denied Claims. If Class Counsel and Toyota jointly recommend payment of the Claims or payment of a reduced claim amount, the Settlement Claims Administrator will be instructed to pay those Claims. If Class Counsel and Toyota’s Counsel disagree, the Settlement Claims Administrator will make a final determination as to whether the Claims should be paid.

Claim Reimbursement. If the settlement is finally approved, including resolving any appeals in favor of upholding the settlement, you can ask to be reimbursed if you (a) are a Class Member;