CLAIMS AUDIT. The Board shall cause a biannual claims audit of the administration of the claims for each of the Programs of PARSAC. A report of such claims review shall be made available for inspection by the Board and the Member Entities. PARSAC shall pay all costs of such claims reviews.
CLAIMS AUDIT. The Company and the Reinsurer may, at any time, elect to appoint an independent auditor. This appointment shall be subject to approval by the Reinsurer. Upon approval, the Reinsurer agrees to pay its proportionate share of the cost of such audit as well as its proportionate share of the final claim. In the event that a claim may be recoverable hereon and the Company does not elect to appoint an independent auditor, the Reinsurer reserves the right to appoint an independent auditor to investigate the potential claim. Should the Reinsurer appoint an independent auditor, all costs of this audit shall be borne by the Reinsurer. The Company agrees that the amount of any claim subsequently recovered upon shall be based entirely on the audited figures irrespective of whether or not the independent auditor has reduced the initial claim.
CLAIMS AUDIT. HPHC shall adhere to the requirements of the Maine Uniform Accounting and Auditing Practices for Community Agencies Act, 5 M.R.S.A. § 1660-C et seq., as required by such law.
CLAIMS AUDIT. Reinsurer shall have the right to audit the claims payment practices and may prescribe claims notice dollar thresholds if it reasonably determines that Ceding Company's claims payment practices and procedures are materially inconsistent with the descriptions thereof contained in Ceding Company’s business guidelines.
CLAIMS AUDIT. (1) Express Scripts Canada may conduct a review or audit the books and records of the Provider relating to any Claims submitted by the Provider under this Agreement in order to ensure compliance with the terms and conditions of this Agreement.
CLAIMS AUDIT a. At Employer's expense, Employer shall have the right to audit Claims on Anthem's premises, during regular business hours and in accordance with Anthem's audit policy, which may be revised from time to time. A copy of the audit policy shall be made available to Employer upon request.
