Disputed Encounter Submissions a. On a quarterly basis, the DMAHS will review the Contractor’s file of pharmacy encounters and send a file back to the Contractor of disputed encounters that were identified through the drug rebate invoicing process.
Disputed Encounter Submissions Sample Clauses
Related to Disputed Encounter Submissions
Claims Review Findings a. Narrative Results.
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.
Claims Review Population A description of the Population subject to the Claims Review.
Encounter Data Party shall provide encounter data to the Agency of Human Services and/or its departments and ensure further that the data and services provided can be linked to and supported by enrollee eligibility files maintained by the State.
Review Protocol A narrative description of how the Claims Review was conducted and what was evaluated.
Problem Statement School bus fleets are aging, and our communities have poor air quality. Replacing school buses with zero emission school buses will address both of these issues.
TIMELINESS OF BILLING SUBMISSION The parties agree that timeliness of billing is of the essence to this Contract and recognize that the City is on a fiscal year. All xxxxxxxx for dates of service prior to July 1 must be submitted to the City no later that the first Friday in August of the same year.
Claims Review Methodology a. C laims Review Population. A description of the Population subject to the Quarterly Claims Review.
Delays and Complaints Delivery delays and service complaints will be monitored on a continual basis. Documented inability to perform under the conditions of the contract, via the Complaint to Vendor process (PUR 7017 form) contemplated for this Contract, may result in default proceedings and cancellation.
Feedback and Complaints 34.1. The primary responsibility for receiving feedback and investigating complaints promptly and thoroughly in respect of the Services shall rest with the Contractor. The Contractor shall have procedures in place, which are acceptable to the ESFA, to gather and act upon feedback and complaints from Learners and/or their representatives and employers and the wider community.
