Claims payment issues arising from departure of Participating Professional Sample Clauses

Claims payment issues arising from departure of Participating Professional. In the event a Participating Professional departs from a medical group that is a Participating Provider, and uncertainty arises as to whether that medical group or some other entity is entitled to receive payment for certain services rendered by such former Participating Professional, the parties will cooperate with each other in good faith in an attempt to resolve the situation appropriately. In the event that Participating Professional’s failure to give timely notice under section 6.14 (iv) of this Agreement resulted in claims payments being made incorrectly to the medical group that is a Participating Provider, that medical group will promptly notify United and return such payments to United. In the event that medical group fails to do so, United may hold the medical group liable for any attorneys’ fees, costs, or administrative expenses incurred by United as a result. In the event that both the medical group that is a Participating Provider and some other entity assert a right to payment for the same service rendered by the former Participating Professional, United may refrain from paying either entity until the entity to which payment is owed is determined. Provided that United acts in good faith, the medical group will waive any right to receive interest or penalties under any applicable law relating to the prompt payment of claims.
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Related to Claims payment issues arising from departure of Participating Professional

  • File Management and Record Retention relating to CRF Eligible Persons or Households Grantee must maintain a separate file for every applicant, Eligible Person, or Household, regardless of whether the request was approved or denied.

  • Files Management and Record Retention relating to Grantee and Administration of this Agreement a. The Grantee shall maintain books, records, and documents in accordance with generally accepted accounting procedures and practices which sufficiently and properly reflect all expenditures of funds provided by Florida Housing under this Agreement.

  • Submitting False Claims; Monetary Penalties The AOC shall be entitled to remedy any false claims, as defined in California Government Code section 12650 et seq., made to the AOC by the Contractor or any Subcontractor under the standards set forth in Government Code section 12650 et seq. Any Contractor or Subcontractor who submits a false claim shall be liable to the AOC for three times the amount of damages that the AOC sustains because of the false claim. A Contractor or Subcontractor who submits a false claim shall also be liable to the AOC for (a) the costs, including attorney fees, of a civil action brought to recover any of those penalties or damages, and (b) a civil penalty of up to $10,000 for each false claim.

  • Claims Payment The Reinsurer will be liable to the Company for its share of the benefits owed under the express contractual terms of the Reinsured Policies and as specified under the terms of this Agreement. The Reinsurer will not participate in any ex gratia payments made by the Company (i.e., payments the Company is not required to make under the Reinsured Policy terms.) The payment of death benefits by the Reinsurer will be in one lump sum regardless of the mode of settlement under the Reinsured Policy. Benefit payments from the Reinsurer will be due within 30 days of the claim satisfying the requirements established under this Agreement. The Reinsurer’s share of any interest payable under the terms of a Reinsured Policy or applicable law which is based on the death benefits paid by the Company, will be payable provided that the Reinsurer will not be liable for interest accruing on or after the date of the Company’s payment of benefits. The Reinsurer will make payment to the Company for each such claim. For Waiver of Premium claims, the Company will continue to pay premiums for reinsurance, except premiums for disability reinsurance. The Reinsurer will pay its proportionate share of the gross premium waived by the Company on the Reinsured Policy, including its share of the premiums for benefits that remain in effect during disability. For claims on Accelerated Benefit riders reinsured under this Agreement, the benefit amount payable by the Reinsurer will be calculated by multiplying the total accelerated death benefit rider payout by the ratio of the reinsured Net Amount at Risk, as defined in Exhibit C-1, to the face amount of the Reinsured Policy.

  • What Will Happen After We Receive Your Letter When we receive your letter, we must do two things:

  • Payment of Paid Personal/Carer’s Leave (a) If an employee takes a period of paid personal/xxxxx’s leave and meets the notice requirements set out at Clause 44.3 the employer must pay the employee at the employee’s base rate of pay for the employee’s ordinary hours of work in the period.

  • CHILD AND DEPENDENT ADULT/ELDER ABUSE REPORTING CONTRACTOR shall establish a procedure acceptable to ADMINISTRATOR to ensure that all employees, agents, subcontractors, and all other individuals performing services under this Agreement report child abuse or neglect to one of the agencies specified in Penal Code Section 11165.9 and dependent adult or elder abuse as defined in Section 15610.07 of the WIC to one of the agencies specified in WIC Section 15630. CONTRACTOR shall require such employees, agents, subcontractors, and all other individuals performing services under this Agreement to sign a statement acknowledging the child abuse reporting requirements set forth in Sections 11166 and 11166.05 of the Penal Code and the dependent adult and elder abuse reporting requirements, as set forth in Section 15630 of the WIC, and shall comply with the provisions of these code sections, as they now exist or as they may hereafter be amended.

  • Returning to Work After a Period of Parental Leave (a) An employee will notify of their intention to return to work after a period of parental leave at least four weeks prior to the expiration of the leave.

  • EMPLOYER AND UNION SHALL ACQUAINT NEW EMPLOYEES The Employer agrees to acquaint new employees with the fact that a Collective Agreement is in effect and with the conditions of employment set out in the Articles dealing with Union Security and Dues Check-off. The Employer agrees to provide the name, worksite phone number, and location of the new employee's xxxxxxx in the letter of hiring. Whenever the xxxxxxx is employed in the same work area as the new employee, the employee's immediate supervisor will introduce her to her xxxxxxx. The Employer agrees that a Union xxxxxxx will be given an opportunity to interview each new employee within regular working hours, without loss of pay, for thirty (30) minutes sometime during the first thirty (30) days of employment for the purpose of acquainting the new employee with the benefits and duties of Union membership and the employee's responsibilities and obligations to the Employer and the Union.

  • Happen After We Receive Your Letter When we receive your letter, we must do two things:

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