Claims Payment Timelines Sample Clauses

Claims Payment Timelines. The Contractor shall pay providers for covered medically necessary services rendered to the Contractor’s members in accordance with the standards set forth in IC 12-15-13-1.6 and IC 12-15-13-1.7, unless the Contractor and provider agree to an alternate payment schedule and method. The Contractor shall also abide by the specifications of 42 CFR 447.45(d)(5) and (d)(6), which require the Contractor to ensure that the date of receipt is the date the Contractor receives the claim, as indicated by its date stamp on the claim; and that the date of payment is the date of the check or other form of payment. The Contractor shall pay or deny electronically filed clean claims within twenty one (21) calendar days of receipt. A “clean claim” is one in which all information required for
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Claims Payment Timelines. The Contractor shall pay providers for covered medically necessary services rendered to the Contractor’s members in accordance with the standards set forth in IC 12-15-13-1.6 and IC 12-15-13-1.7, unless the Contractor and provider agree to an alternate payment schedule and method. The Contractor shall also abide by the specifications of 42 CFR 447.45(d)(5) and (d)(6), which require the Contractor to ensure that the date of receipt is the date the Contractor receives the claim, as indicated by its date stamp on the claim; and that the date of payment is the date of the check or other form of payment. The Contractor shall pay or deny electronically filed clean claims within twenty one (21) calendar days of receipt. A “clean claim” is one in which all information required for As provided in 42 CFR 447.46(c)(2), the Contractor may, by mutual agreement, establish an alternative payment schedule with in-network providers. The alternative payment schedule shall be outlined in the provider agreement described in Section 8.4. However, the alternate
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Related to Claims Payment Timelines

  • 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.

  • PROGRESS PAYMENT 5.4.1 After receipt by the Contract Administrator of a Proper Invoice submitted by the Contractor in accordance with 5.3 – PROPER INVOICES:

  • Claims Plus Claims Plus is a service that provides notice to Registrars that a domain name they are trying to register matches a trademark registered in a trademark database used by the Registry Operator. SPECIFICATION 1 CONSENSUS POLICIES AND TEMPORARY POLICIES SPECIFICATION

  • Payment Claims Subject to clause 11.3, the Contractor must give the PDS Contractor claims for payment on account of the Contract Price and all other amounts then payable by the Commonwealth to the Contractor under the Contract: at the times specified in the Contract Particulars until Completion or termination of the Contract (whichever is earlier); unless terminated earlier: after Completion, within 28 days (or such longer period agreed in writing by the PDS Contractor) after the issue of a Completion certificate under clause 13.1; and after the Defects Liability Period, within the time required by clause 11.9; in the format set out in the Schedule of Collateral Documents or in any other format which the PDS Contractor reasonably requires; which are based on the Table of Variation Rates and Prices or the Schedule of Rates to the extent these are relevant; which show separately the amounts (if any) claimed on account of the: Contract Price; and all other amounts then payable by the Commonwealth to the Contractor under the Contract; and which set out or attach sufficient details, calculations, supporting documentation and other information in respect of all amounts claimed by the Contractor: to enable the PDS Contractor to fully and accurately determine (without needing to refer to any other documentation or information) the amounts then payable by the Commonwealth to the Contractor under the Contract; and including any such documentation or information which the PDS Contractor may by written notice from time to time require the Contractor to set out or attach, whether in relation to a specific payment claim or all payment claims generally.

  • Progress Payments 5.1.1 Based upon Applications for Payment submitted to the Architect by the Contractor and Certificates for Payment issued by the Architect, the Owner shall make progress payments on account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents.

  • Claim Form i. Within 15 days after receiving a notice of a claim, you or your Dental Provider will be provided with a Claim Form to make claim for Benefits. To make a claim, the form should be completed and signed by the Provider who performed the services, and by the patient (or the parent or guardian if the patient is a minor), and submitted to the address above.

  • 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.

  • Billing, Payment, Milestones, and Financial Security 6.1 Billing and Payment Procedures and Final Accounting

  • Compensation Claims (a) The Employer agrees to cooperate toward the prompt disposition of employee on-the-job injury claims. The Employer shall provide worker’s compensation protection for all employees even though not required by state law, or the equivalent thereof, if the injury arose out of or in the course of employment. No employee will be disciplined or threatened with discipline as a result of filing an on-the-job injury report. The Employer or its designee shall not visit an injured worker at his/her home, at a hospital or any location outside the employee’s home terminal without his/her consent.

  • Claims Review Population A description of the Population subject to the Claims Review.

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