Claims Submissions Sample Clauses

The Claims Submissions clause outlines the procedures and requirements for submitting claims under a contract or insurance policy. It typically specifies the timeframe within which claims must be filed, the documentation or evidence required, and the method of submission, such as through a designated portal or in writing. By establishing clear guidelines for how and when claims should be submitted, this clause helps ensure timely processing and reduces disputes over eligibility or payment.
Claims Submissions. Practice shall submit all claims and encounter data for Covered Services provided to Enrollees by Participating Physicians in accordance with form and format requirements of HMHP or the applicable Payor.
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Claims Submissions a. The Contractor shall submit claims to AHCCCS in accordance with the ADHS/DBHS Program Support Procedures Manual, ADHS/DBHS Provider Manual, and the Financial Reporting Guide for Regional Behavioral Health Authorities as applicable to 638 contracted facilities. The Contractor shall meet all timeliness requirements of submitting claims as outlined in the ADHS/DBHS Program Support Procedures Manual. The Contractor shall meet all claims submission requirements including timeliness of claims or be subject to financial sanction. b. The Contractor shall require subcontracted providers to submit claims for every service rendered to a client in accordance with claims submission requirements outlined in the ADHS/DBHS Provider Manual and the AHCCCS Fee-for-Services Manual. c. The Contractor shall participate in data validations studies in accordance with Terms and Conditions Paragraph G. Compliance Provisions and the ADHS/DBHS Program Support Procedures Manual as applicable to 638 contracted facilities.
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Claims Submissions. The Employer will ensure that any claims for benefits submitted by the employee due to the job related injury are forwarded to the appropriate authorities as soon as possible.
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Related to Claims Submissions

  • Claims Submission We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

  • SUBMISSIONS You acknowledge and agree that any questions, comments, suggestions, ideas, feedback, or other information regarding the Site ("Submissions") provided by you to us are non-confidential and shall become our sole property. We shall own exclusive rights, including all intellectual property rights, and shall be entitled to the unrestricted use and dissemination of these Submissions for any lawful purpose, commercial or otherwise, without acknowledgment or compensation to you. You hereby waive all moral rights to any such Submissions, and you hereby warrant that any such Submissions are original with you or that you have the right to submit such Submissions. You agree there shall be no recourse against us for any alleged or actual infringement or misappropriation of any proprietary right in your Submissions.

  • Third Party Applications Oracle or third party providers may offer Third Party Applications. Except as expressly set forth in the Estimate/Order Form, Oracle does not warrant any such Third Party Applications, regardless of whether or not such Third Party Applications are provided by a third party that is a member of an Oracle partner program or otherwise designated by Oracle as “Built For NetSuite,” "certified," "approved" or “recommended.” Any procurement by Customer of such Third Party Applications or services is solely between Customer and the applicable third party provider. Customer may not use Third Party Applications to enter and/or submit transactions to be processed and/or stored in the Cloud Service, unless Customer has procured the applicable subscription to the Cloud Service for such use and access.

  • Errors, Questions, and Complaints a. In case of errors or questions about your transactions, you should as soon as possible contact us as set forth in Section 6 of the General Terms above. b. If you think your periodic statement for your account is incorrect or you need more information about a transaction listed in the periodic statement for your account, we must hear from you no later than sixty (60) days after we send you the applicable periodic statement for your account that identifies the error. You must: 1. Tell us your name; 2. Describe the error or the transaction in question, and explain as clearly as possible why you believe it is an error or why you need more information; and, 3. Tell us the dollar amount of the suspected error. c. If you tell us orally, we may require that you send your complaint in writing within ten (10) Business Days after your oral notification. Except as described below, we will determine whether an error occurred within ten (10) Business Days after you notify us of the error. We will tell you the results of our investigation within three (3) Business Days after we complete our investigation of the error, and will correct any error promptly. However, if we require more time to confirm the nature of your complaint or question, we reserve the right to take up to forty-five (45) days to complete our investigation. If we decide to do this, we will provisionally credit your Eligible Transaction Account within ten (10) Business Days for the amount you think is in error. If we ask you to submit your complaint or question in writing and we do not receive it within ten (10) Business Days, we may not provisionally credit your Eligible Transaction Account. If it is determined there was no error we will mail you a written explanation within three (3) Business Days after completion of our investigation. You may ask for copies of documents used in our investigation. We may revoke any provisional credit provided to you if we find an error did not occur.

  • Claims Review The IRO shall perform the Claims Review annually to cover each of the five Reporting Periods. The IRO shall perform all components of each Claims Review.