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Clean Claim Requirement Sample Clauses

Clean Claim RequirementClaims for payment submitted to the TPA must constitute “clean claims” which are those claims that are completely and accurately filled out. The TPA shall reject, and shall have no responsibility to pay, any claim that does not include the elements of a clean claim. The TPA shall notify the Provider of the reason for denial; Provider may correct the claim and submit it again for payment. The claim for payment of services must include the following in order to constitute a clean claim: a. Each member’s invoice must be a separate xxxx, including the member's full name; b. Attach a copy of the letter of authorization for each service billed or include the authorization number on your xxxx; c. Invoice must be in readable format; d. Identify charges by service description or procedure code (as indicated on the authorization); e. Actual delivery date(s) of EACH service; f. Number of units of service provided on each date; and g. Total amount billed per service. Claims that are denied payment may be corrected and submitted again, including all of the above elements. Claims that have been partially paid may be resubmitted for reprocessing, following the TPA requirements for reprocessing claims.
Clean Claim Requirement. Medivolve represents and warrants to MassLabs that the individual encounter data provided to MassLabs is complete and contains all data required for submission and reimbursement from insurance plans, patients or account guarantors. If an incomplete encounter (super bill) is submitted to MassLabs and is deemed unbillable, a request for the missing data will be provided to Medivolve and no further action will be taken on the encounter until the missing data is provided. MassLabs will maintain a list of all the outstanding items and Medivolve will have access to the list through the Online Software Service interface for audit and resolution.

Related to Clean Claim Requirement

  • W-9 Requirement Alongside a signed copy of this Agreement, Grantee will provide Florida Housing with a properly completed Internal Revenue Service (“IRS”) Form W-9. The purpose of the W-9 form is to document the SS# or FEIN# per the IRS. Note: W-9s submitted for any other entity name other than the Grantee’s will not be accepted.

  • Removal Requirement If Xxxxxx has actual notice that a Covered Person has become an Ineligible Person, Xxxxxx shall remove such Covered Person from responsibility for, or involvement with, Xxxxxx’x business operations related to the Federal health care program(s) from which such Covered Person has been excluded and shall remove such Covered Person from any position for which the Covered Person’s compensation or the items or services furnished, ordered, or prescribed by the Covered Person are paid in whole or part, directly or indirectly, by any Federal health care program(s) from which the Covered Person has been excluded at least until such time as the Covered Person is reinstated into participation in such Federal health care program(s).‌

  • Required Confidentiality Claim Form This is a requirement of the TIPS Contract and is non-negotiable. TIPS provides the required TIPS Confidentiality Claim Form in the "Attachments" section of this solicitation. Vendor must execute this form by either signing and waiving any confidentiality claim, or designating portions of Vendor's proposal confidential. If Vendor considers any portion of Vendor's proposal to be confidential and not subject to public disclosure pursuant to Chapter 552 Texas Gov’t Code or other law(s) and orders, Vendor must have identified the claimed confidential materials through proper execution of the Confidentiality Claim Form. If TIPS receives a public information act or similar request, any responsive documentation not deemed confidential by you in this manner will be automatically released. For Vendor documents deemed confidential by you in this manner, TIPS will follow procedures of controlling statute(s) regarding any claim of confidentiality and shall not be liable for any release of information required by law, including Attorney General determination and opinion. Notwithstanding any other Vendor designation of Vendor's proposal as confidential or proprietary, Vendor’s submission of this proposal constitutes Vendor’s agreement that proper execution of the required TIPS Confidentiality Claim Form is the only way to assert any portion of Vendor's proposal as confidential.

  • ARBITRATION REQUIREMENT EXCEPT AS STATED BELOW, ANY DISPUTE BETWEEN YOU AND ANY OF US SHALL BE DECIDED BY NEUTRAL, BINDING ARBITRATION RATHER THAN IN COURT OR BY JURY TRIAL. “Dispute” will be given the broadest possible meaning allowable by law. It includes any dispute, claim, or controversy arising from or relating to your purchase of this heating or air conditioning unit, any warranty upon the unit, or the unit’s condition. It also includes determination of the scope or applicability of this Arbitration Clause. The arbitration requirement applies to claims in contract and tort, pursuant to statute, or otherwise.

  • Federal Medicaid System Security Requirements Compliance Party shall provide a security plan, risk assessment, and security controls review document within three months of the start date of this Agreement (and update it annually thereafter) in order to support audit compliance with 45 CFR 95.621 subpart F, ADP System Security Requirements and Review Process.

  • CONTRACT COMPLIANCE REQUIREMENT The HUB requirement on this Contract is 0%. The student engagement requirement of this Contract is 0 hours. The Career Education requirement for this Contract is 0 hours. Failure to achieve these requirements may result in the application of some or all of the sanctions set forth in Administrative Policy 3.10, which is hereby incorporated by reference.

  • General Requirement Any notice, election, demand, request, consent, approval, or other communication required or permitted to be given under this Contract shall be in writing signed by an officer or duly authorized representative of the party making same and shall be delivered personally or shall be sent by certified or statutory mail, postage prepaid, return receipt requested, shall be effective as of the date on which it is received or would have been received but for the refusal of the addressee to accept delivery, and shall be addressed as shown in the Contract. The persons and addresses to which notices should be given may be changed by notice given in accordance with this Article.