Common use of Compensation and Billing Clause in Contracts

Compensation and Billing. 1. Group's reimbursement for Covered Services provided to Beneficiaries of Payors participating in this Program shall be the rates set forth and attached hereto in Exhibit A to this Attachment, less applicable Copayments, Deductibles, and Coinsurance, and any applicable administrative fees, which shall not exceed 4%. The rates set forth in Exhibit A to this Attachment shall apply to all Health Care Services rendered to Beneficiaries in the OhioHealthy Program. 2. Group will look solely to Payor for compensation for Covered Services except for Copayments, Deductibles or Coinsurance. Group agrees, that whether or not there is any unresolved dispute for payment, that under no circumstances will Group directly or indirectly make any charges or claims for Covered Services, other than for Copayments, Deductibles or Coinsurance, against any Beneficiaries or their representatives and that this provision survives termination of this Attachment for services rendered prior to such termination. Except for the collection of Copayments, Deductibles or Coinsurance, only those services that are not Covered Services may be billed directly to Beneficiaries, subject to limitations listed above. This paragraph is to be interpreted for the benefit of Beneficiaries and does not diminish the obligation of a Payor to make payments to Group according to the terms of this Agreement. 3. OhioHealthy will remit any amount owing under this OhioHealthy Program Attachment and the Agreement within thirty (30) days after receipt of a complete claim from Group. Payor shall pay claims consistent with Ohio Revised Code sections 3901.381 – 3901.3814. For purposes of this Attachment, a "complete claim" is defined in the Agreement and supplemented by the applicable Payor's Program Manual.

Compensation and Billing. 1. GroupProvider 's reimbursement for Covered Services provided to Beneficiaries of Payors participating in this Program shall be the rates set forth and attached hereto in Exhibit A to this Attachment, less applicable Copayments, Deductibles, and Coinsurance, and any applicable administrative fees, which shall not exceed 4%. The rates set forth in Exhibit A to this Attachment shall apply to all Health Care Services rendered to Beneficiaries in the OhioHealthy Program. 2. Group Provider will look solely to Payor for compensation for Covered Services except for Copayments, Deductibles or Coinsurance. Group Provider agrees, that whether or not there is any unresolved dispute for payment, that under no circumstances will Group Provider directly or indirectly make any charges or claims for Covered Services, other than for Copayments, Deductibles or Coinsurance, against any Beneficiaries or their representatives and that this provision survives termination of this Attachment for services rendered prior to such termination. Except for the collection of Copayments, Deductibles or Coinsurance, only those services that are not Covered Services may be billed directly to Beneficiaries, subject to limitations listed above. This paragraph is to be interpreted for the benefit of Beneficiaries and does not diminish the obligation of a Payor to make payments to Group Provider according to the terms of this Agreement. 3. OhioHealthy will remit any amount owing under this OhioHealthy Program Attachment and the Agreement within thirty (30) days after receipt of a complete claim from GroupProvider. Payor shall pay claims consistent with Ohio Revised Code sections 3901.381 – 3901.3814. For purposes of this Attachment, a "complete claim" is defined in the Agreement and supplemented by the applicable Payor's Program Manual.

Compensation and Billing. 1. GroupProvider 's reimbursement for Covered Services provided to Beneficiaries of Payors participating in this Program shall be the rates set forth and attached hereto in Exhibit A to this Attachment, less applicable Copayments, Deductibles, and Coinsurance, and any applicable administrative fees, which shall not exceed 4%. The rates set forth in Exhibit A to this Attachment shall apply to all Health Care Services rendered to Beneficiaries in the OhioHealthy Program. 2. Group Provider will look solely to Payor for compensation for Covered Services except for Copayments, Deductibles or Coinsurance. Group Provider agrees, that whether or not there is any unresolved dispute for payment, that under no circumstances will Group Provider directly or indirectly make any charges or claims for Covered Services, other than for Copayments, Deductibles or Coinsurance, against any Beneficiaries or their representatives and that this provision survives termination of this Attachment for services rendered prior to such termination. Except for the collection of Copayments, Deductibles or Coinsurance, only those services that are not Covered Services may be billed directly to Beneficiaries, subject to limitations listed above. This paragraph is to be interpreted for the benefit of Beneficiaries and does not diminish the obligation of a Payor to make payments to Group Provider according to the terms of this Agreement. 3. OhioHealthy will remit any amount owing under this OhioHealthy Program Attachment and the Agreement within thirty (30) days after receipt of a complete claim from GroupProvider. Payor shall pay claims consistent with Ohio Revised Code sections 3901.381 – 3901.3814. For purposes of this Attachment, a "complete claim" is defined in the Agreement and supplemented by the applicable Payor's Program Manual.