Common use of Clean Claim Clause in Contracts

Clean Claim. A Claim submitted by a physician or Provider for health care services rendered to an Enrollee, with the data necessary for the STAR+PLUS MMP or subcontracted Claims processor to adjudicate and accurately report the Claim. A Clean Claim other than a Nursing Facility Services Clean Claim must meet all requirements for accurate and complete data as defined in the appropriate Claim type encounter guides as follows:

Clean Claim. A Claim submitted by a physician or Provider for health care services rendered to an Enrollee, with the data necessary for the STAR+PLUS MMP or subcontracted Claims processor to adjudicate and accurately report the Claim. A Clean Claim other than a Nursing Facility Services Unit Rate Clean Claim must meet all requirements for accurate and complete data as defined in the appropriate Claim type encounter Encounter guides as follows: