Claims Processing Time. At least ninety-five percent (95%) of all claims received must be processed within thirty (30) calendar DAYS of receipt of all necessary information, except for those claims for which the HEALTH BENEFIT PROGRAM is the secondary payer. (See Section III.
Claims Processing Time. At least ninety-eight percent (98%) of all claims received must be processed within three (3) BUSINESS DAYS of CONTRACTOR’S receipt of all necessary substantiation information. (See Section 160 Claims.) Monthly performance standard statistic, reported QUARTERLY. One thousand dollars ($1,000) for each percentage point (or fraction thereof) for which the standard is not met in each QUARTER.
Claims Processing Time. At least ninety-five percent (95%) of all Five thousand ($5,000) dollars for each percentage point for which the standard is not met in each quarter claims received must be processed within thirty (30) calendar DAYS of receipt of all necessary information, except for those claims for which the HEALTH BENEFIT PROGRAM is the secondary payer. (See Section 235.)
Claims Processing Time. At least ninety-nine and one-half Five thousand percent (99.5%) of the time claims are paid (including reversals and ($5,000) dollars for adjustments) in accordance with the pharmacy contract each percentage reimbursement provisions effective at the time the claim is point for which the adjudicated. See Section 230. standard is not met in each month
