Common use of Claims Submission Clause in Contracts

Claims Submission. Provider will submit acceptable claims for Members’ Covered Services, and for Out-of-Panel Services unless otherwise specified by such member’s Alternative Delivery System, directly to BCBSM using BCBSM approved claim forms, direct data entry systems, tape-to-tape systems or such other methods as BCBSM may approve from time to time. An acceptable claim is one which complies with the requirements stated in published BCBSM administrative manuals or additional published guidelines and criteria. All claims shall be submitted within 180 days of the date(s) of service. Claims submitted more than 180 days after the date(s) of service, shall not be entitled to reimbursement from either BCBSM or a Member except as set forth in Addendum G, or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.

Claims Submission. Provider will submit acceptable claims for Members’ Covered Services, and for Out-of-Panel Services unless otherwise specified by such member’s Alternative Delivery System, directly to BCBSM using BCBSM approved claim forms, direct data entry systems, tape-to-tape systems or such other methods as BCBSM may approve from time to time. An acceptable claim is one which complies with the requirements stated in published BCBSM administrative manuals or additional other published guidelines and criteria. All claims shall be submitted within 180 days of the date(s) of service. Claims submitted more than 180 days after the date(s) of service, shall not be entitled to reimbursement from either BCBSM or a Member except as set forth in Addendum GF., or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.E.

Claims Submission. Provider Facility will submit acceptable claims for Members’ Covered Services, and for Out-of-Panel Services unless otherwise specified by such member’s Alternative Delivery System, directly to BCBSM using BCBSM approved claim forms, direct data entry systemssystems (e.g., tape-to-tape systems EDI), or such other methods as BCBSM may approve from time to time. An acceptable claim is one which complies with the requirements stated in published BCBSM administrative provider manuals or additional published guidelines and criteria. All claims shall be submitted within 180 days of the date(s) of service. Claims submitted more than 180 days after the date(s) of service, shall not be entitled to reimbursement from either BCBSM or a Member except as set forth in Addendum G, or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider Facility will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.

Claims Submission. Provider will submit acceptable claims for Members’ Covered Services, and for Out-of-Panel Services unless otherwise specified by such member’s Alternative Delivery System, directly to BCBSM o r B C N using BCBSM o r B C N approved claim forms, direct data entry systems, tape-to-tape systems or such other methods as BCBSM or BCN may approve from time to time. An acceptable claim is one which complies with the requirements stated in published BCBSM and BCN administrative manuals or additional published guidelines and criteria. All claims shall be submitted within 180 days of the date(s) of service. Claims submitted more than 180 days after the date(s) of service, shall not be entitled to reimbursement from either BCBSM BCBSM, BCN or a Member except as set forth in Addendum GF, or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.E.

Claims Submission. Provider Facility will submit acceptable claims for Members’ Covered Services, and for Out-ofOf-Panel Services services unless otherwise specified by such member’s 's Alternative Delivery System, directly to BCBSM using BCBSM approved claim forms, direct data entry systems, tape-to-tape systems or such other methods as BCBSM may approve from time to time. An acceptable claim is one which a claim that BCBSM determines complies with the requirements stated in published BCBSM administrative manuals or additional published guidelines and criteria. All claims shall be submitted within 180 days 12 months of the date(s) date of service. Claims submitted more than 180 days 12 months after the date(s) date of service, service shall not be entitled to reimbursement from either BCBSM or a Member except as set forth in Addendum G, or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider Facility will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.

Claims Submission. Provider Facility will submit acceptable claims for Members’ Covered Services, and for Out-ofOf-Panel Services services unless otherwise specified by such member’s 's Alternative Delivery System, directly to BCBSM using BCBSM approved claim forms, direct data entry systems, tape-to-tape systems or such other methods as BCBSM may approve from time to time. An acceptable claim is one which a claim BCBSM determines complies with the requirements stated in published BCBSM administrative manuals or additional published guidelines and criteria. All claims shall be submitted within 180 days 12 months of the date(s) date of service. Claims submitted more than 180 days 12 months after the date(s) date of service, service shall not be entitled to reimbursement from either BCBSM or a Member except as set forth in Addendum G, or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider Facility will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.

Claims Submission. Provider Facility will submit acceptable claims Clean Claims for Members’ Covered Services, and for Out-of-Panel Services unless otherwise specified by such member’s Alternative Delivery System, directly to BCBSM using BCBSM approved claim forms, direct data entry systems, tape-to-tape systems or such other methods as BCBSM may approve from time to time. An acceptable claim A Clean Claim is one which complies with the requirements stated in published BCBSM administrative manuals or additional published guidelines and criteria. All claims shall be submitted within 180 days of the date(s) of service. Claims submitted more than 180 days after the date(s) of service, shall not be entitled to reimbursement from either BCBSM or a Member except as set forth in Addendum GF, or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider Facility will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.E.

Claims Submission. Provider will submit acceptable claims for Members’ Covered Services, and for Out-of-Panel Services unless otherwise specified by such member’s Alternative Delivery System, directly to BCBSM using BCBSM approved claim forms, direct data entry systems, tape-to-tape systems or such other methods as BCBSM may approve from time to time. An acceptable claim is one which complies with the requirements stated in published BCBSM administrative manuals or additional other published guidelines and criteria. All claims shall be submitted within 180 days of the date(s) of service. Claims submitted more than 180 days after the date(s) of service, shall not be entitled to reimbursement from either BCBSM or a Member except as set forth in Addendum G, or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.

Claims Submission. Provider will submit acceptable claims for Members’ Covered Services, and for Out-of-Panel Services unless otherwise specified by such member’s Alternative Delivery System, directly to BCBSM using BCBSM approved claim forms, direct data entry systems, tape-to-tape systems or such other methods as BCBSM may approve from time to time. An acceptable claim is one which complies with the requirements stated in published BCBSM administrative manuals or additional published guidelines and criteria. All claims shall be submitted within 180 days of the date(s) of service. Claims submitted more than 180 days after the date(s) of service, shall not be entitled to reimbursement from either BCBSM or a Member except as set forth in Addendum G, or except as may be provided in the standard reimbursement policies or contractual arrangements between an Alternative Delivery System and its members. Provider will endeavor to file complete and accurate claims and report overpayments in accordance with the Service Reporting and Claims Overpayment Policy attached as Addendum F.