Common use of Corrective Adjustments for Overpayments Clause in Contracts

Corrective Adjustments for Overpayments. (a) In accordance with TAC § 21.2818, United or Payer may recover a refund from Provider due to overpayment or completion of an audit, by adjusting future claim payments and/or by billing Provider for the amount of the overpayment, if (i) United notifies Provider of the overpayment not later than the 180th day after the date of receipt of the overpayment; or (ii) United notifies Provider of the completion of an audit under TAC § 21.2809. Notification under subsection (i) of this section shall be in writing and shall include: (A) the specific claims and amounts for which a refund is due and for each claim the basis and specific reasons for the request for refund; (B) notice of Provider’s right to appeal; and (C) the methods by which United intends to recover the refund.

Corrective Adjustments for Overpayments. (a) In accordance with TAC § 21.2818, United we or Payer the participating entity may recover a refund from Provider you due to overpayment or completion of an audit, by adjusting future claim payments and/or by billing Provider you for the amount of the overpayment, if if: (i) United notifies Provider we notify you of the overpayment not later than the 180th day after the date of receipt of the overpayment; or (ii) United notifies Provider we notify you of the completion of an audit under TAC § 21.2809. Notification under subsection (i) of this section shall be in writing and shall include: (A) the specific claims and amounts for which a refund is due and for each claim the basis and specific reasons for the request for refund; (B) notice of Provider’s your right to appeal; and (C) the methods by which United intends you intend to recover the refund.

Corrective Adjustments for Overpayments. (a) In accordance with TAC § 21.2818, United we or Payer the participating entity may recover a refund from Provider you due to overpayment or completion of an audit, by adjusting future claim payments and/or by billing Provider you for the amount of the overpayment, if (i) United notifies Provider we notify you of the overpayment not later than the 180th day after the date of receipt of the overpayment; or (ii) United notifies Provider we notify you of the completion of an audit under TAC § 21.2809. Notification under subsection (i) of this section shall be in writing and shall include: (A) the specific claims and amounts for which a refund is due and for each claim the basis and specific reasons for the request for refund; (B) notice of Provider’s your right to appeal; and (C) the methods by which United intends we or the participating entity intend to recover the refund.