Electronic Data Interchange (EDI) Request Form Sample Clauses

Electronic Data Interchange (EDI) Request Form. 9.01 The EDI Request Form, Exhibit II of this agreement, outlines all transactions used between TDH and the Trading Partner including HIPAA transactions and proprietary formats. For most proprietary formats, the transaction name is sufficient identification information; however, a file format and/or additional clarification data for any proprietary format may be appended to the EDI Request Form, if needed. 9.02 Updates to the EDI Request Form may be made at any time by mutual agreement of both parties. Each update of the EDI Request Form supersedes all prior versions. Therefore, each EDI Request Form must contain all transactions between both parties. 9.03 All transactions received by TDH may receive a 997 acknowledgement regardless of their HIPAA status. 9.04 Each Trading Partner has the option to send back to TDH 997 acknowledgement transactions on all formats. The Trading Partner must indicate their acknowledgement intent for every transaction on the EDI Request Form. 9.05 Any transaction, per the Trading Partner Agreement, requiring an acknowledgement back to TDH where an acknowledgement is not received, will result in a transmission re-send before the next update cycle is processed. 9.06 The “Transaction Frequency” column should contain the anticipated normal frequency of this transaction. Anticipated values are “D” for daily, “W” for weekly, “S” for semi-monthly, “M” for monthly, “Q” for quarterly, “A” for annually, “R” for on-request, “O” for other. Multiple indicators may be used for a transaction that has multiple processing cycles. 9.07 The “Transaction Source” column should contain the origination source for the transaction. For transactions that come from TDH, this column is already filled in with “TDH”. For transactions from the Trading Partner, “TP” may be used. For transactions created by a third party for the Trading Partner, enter the third parties name. 9.08 The trading partner access person column should contain the name(s) of all individuals listed on the Security Forms below that will be accessing the given transaction. 9.09 The blank transaction rows on the request form are for proprietary file formats. Each production file sent between TDH and the Trading Partner should be represented on this form. Trading Partners that have multiple sources for a given transaction should include the file once for each source. 9.10 Each trading partner will have a unique TDH submitter ID. The submitter ID will be based upon tax ID - EIN or SSN – sinc...
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Related to Electronic Data Interchange (EDI) Request Form

  • Electronic Data Interchange (EDI This standard establishes the data contents of the Invoice Transaction Set (810) for use within the context of an EDI environment. This transaction set can be used for invoicing via the AN for catalog and non-catalog goods and services.

  • Electronic Data Interchange If both Parties elect to facilitate business activities hereunder by electronically sending and receiving data in agreed formats (also referred to as Electronic Data Interchange or “EDI”) in substitution for conventional paper-based documents, the terms and conditions of this Agreement shall apply to such EDI activities.

  • Electronic Check Conversion/Electronic Returned Check Fees If you pay for purchases or bills with a check or draft, you may authorize your check or draft to be converted to an electronic fund transfer. You may also authorize merchants or other payees to electronically debit your account for returned check fees. You are considered to have authorized these electronic fund transfers if you complete the transaction after being told (orally or by a notice posted or sent to you) that the transfer may be processed electronically or if you sign a written authorization.

  • Electronic Visit Verification ("EVV A. To ensure: 1. the EVV system is used to verify the provision of services governed under 40 TAC, Chapter 68 or its successor; 2. only authorized people access the Contractor's EVV account; 3. all data elements required by HHSC or HHSC's designee are uploaded or entered and maintained in the EVV system completely, accurately, and prior to submitting the claim; 4. that each time services governed by 40 TAC Chapter 68 or its successor are delivered to an individual, the Contractor's staff uses an HHSC-approved EVV system; and 5. service delivery documentation is immediately available for review by HHSC when requested. B. Equipment provided to Contractor by HHSC, HHSC’s designee, or an HHSC-approved EVV vendor, must be returned in good condition when the equipment is no longer needed under this Contract. In the context of this agreement, “good condition” means Contractor must not place any marks or identifying information on the equipment and may not alter information on the equipment including logos and serial numbers. If the equipment is lost, stolen, marked, altered or damaged by Contractor, Contractor may be required to pay the replacement cost for each piece of equipment that is lost, stolen, marked or damaged. Replacement costs for lost, stolen, marked or damaged equipment may be assessed periodically. If Contractor recovers previously lost or stolen equipment for which Contractor paid the replacement cost in the prior 12 months, Contractor may return the equipment and be reimbursed for the replacement costs within 12 months of the date HHSC, HHSC’s designee or an HHSC-approved EVV vendor (as applicable) received payment in full from the Contractor. This is provided the equipment is returned in good condition as specified above. C. HHSC may perform EVV compliance oversight reviews to determine if Contractor has complied with EVV compliance requirements as outlined in 40 TAC Chapter 68 or its successor, EVV Policy posted on the HHSC EVV website or EVV Policy Handbook. D. If the Contractor determines an electronic record in the EVV system needs to be adjusted at any time, the Contractor will make the adjustment in the EVV system using the most appropriate EVV reason code number(s), EVV reason code description(s) and enter any required free text when completing visit maintenance in the EVV system, if applicable. E. Contractor must begin using an HHSC-approved EVV system prior to submitting an EVV relevant claim. F. All claims for services required to use EVV (EVV claims) must match to an accepted EVV visit transaction in the EVV Aggregator (the state’s centralized EVV database) prior to reimbursement of an EVV claim. Without a matching accepted EVV visit transaction, the claim will be denied. G. Contractor must submit all EVV related claims through the Texas Medicaid Claims Administrator, or as otherwise described in the EVV Policy posted on the HHSC EVV website or in the EVV Policy Handbook. H. Contractor must complete all required EVV training as outlined in the EVV Policy posted on the HHSC EVV website or EVV Policy Handbook: • Prior to using either an EVV vendor system or an EVV proprietary system and • Yearly thereafter. I. Contractor and, if applicable, the Contractor’s appointed EVV system administrator, must complete, sign and date the EVV Onboarding Form as outlined in 40 TAC Chapter 68 or its successor, EVV Policy posted on the HHSC website or EVV Policy Handbook.

  • Electronic Funds Transfer (EFT) The recipient/cooperator shall designate a financial institution or an authorized payment agent through which a federal payment may be made in accordance with US Treasury Regulations, Money and Finance at 00 XXX 000, which requires that federal payments are to be made by EFT to the maximum extent possible. A waiver may be requested and payments received by check by certifying in writing that one of the following situations apply: 1. The payment recipient does not have an account at a financial institution. 2. EFT creates a financial hardship because direct deposit will cost the payment recipient more than receiving a check. 3. The payment recipient has a physical or mental disability, or a geographic, language, or literacy barrier. In order to receive EFT payments the recipient/cooperator shall register in the System for Award Management (XXX). You may register by going to xxx.xxx.gov and following the instructions provided online. For assistance, contact the XXX User Help by contacting the supporting Federal Service Desk at (000)000-0000 or xxx.xxx.xxx .

  • Electronic Data 7.1.1 The parties recognize that Contract Documents, including drawings, specifications and three-dimensional modeling (such as Building Information Models) and other Work Product may be transmitted among Owner, Design-Builder and others in electronic media as an alternative to paper hard copies (collectively “Electronic Data”).

  • Instruction; Etc The Underwriters, for and on behalf of each of the Investors, hereby irrevocably instruct the Escrow Agent, and the Escrow Agent agrees: (a) to enter into the Deposit Agreement, and, if applicable, in accordance with Section 5 of the Note Purchase Agreement, to enter into a Replacement Deposit Agreement with the Replacement Depositary; (b) to appoint the Paying Agent as provided in this Agreement; (c) upon receipt at any time and from time to time prior to the Termination Date (as defined below) of a certificate substantially in the form of Exhibit B hereto (a “Withdrawal Certificate”) executed by the Pass Through Trustee, together with an attached Notice of Purchase Withdrawal in substantially the form of Exhibit A to the Deposit Agreement duly completed by the Pass Through Trustee (the “Applicable Notice of Purchase Withdrawal” and the withdrawal to which it relates, a “Purchase Withdrawal”), immediately to execute the Applicable Notice of Purchase Withdrawal as Escrow Agent and transmit it to the Depositary by facsimile transmission in accordance with the Deposit Agreement; provided that, upon the request of the Pass Through Trustee after such transmission, the Escrow Agent shall cancel such Applicable Notice of Purchase Withdrawal; (d) upon receipt of a Withdrawal Certificate executed by the Pass Through Trustee, together with an attached Notice of Replacement Withdrawal (as such term is defined in the Deposit Agreement) in substantially the form of Exhibit C to the Deposit Agreement duly completed by the Pass Through Trustee, to:

  • ELECTRONIC WORKFLOW SYSTEM OGS reserves the right to incorporate an electronic workflow system that may include elements of the Authorized User RFQ process. OGS reserves the right to post Authorized User Contract usage of Centralized Contracts. For Lot 4 only, when provided for in the RFQ and resultant Authorized User Agreement, the Authorized Users may reimburse travel expenses. All rules and regulations associated with this travel can be found at xxxx://xxx.xxxxx.xx.xx/agencies/travel/travel.htm. In no case will any travel reimbursement be charged that exceeds these rates. All travel will be paid only as specified within the Authorized User Agreement and must be billed with the associated services on the same Invoice with receipts attached. The Contractor shall receive prior approval from the Authorized User for any travel that occurs during the term of an Authorized User Agreement. Parking fees and/or parking tickets shall not be paid by an Authorized User. Unless otherwise specified in writing by the Authorized User, a vehicle will not be provided by Authorized User to the Contractor for travel. Therefore, the Contractor will be responsible for ensuring that the Contractor has access to an appropriate vehicle (e.g., personal vehicle or rental vehicle) or common carrier with which to carry out any necessary travel. For the Contractor to obtain reimbursement for the use of a rental vehicle, such use must be justified as the most cost- effective mode of transportation under the circumstances (including consideration of the most effective use of time). The Contractor is responsible for keeping adequate records to substantiate any claims for travel reimbursement. All services provided under the resultant Authorized User Agreement must be performed within CONUS. There are no BONDS for this Contract. However, an Authorized User may require in an RFQ a performance, payment or Bid bond, or negotiable irrevocable letter of credit or other form of security for the faithful performance for the resultant Authorized User Agreement. Pursuant to New York State Executive Law Article 15-A and Parts 140-145 of Title 5 of the New York Codes, Rules and Regulations (“NYCRR”), the New York State Office of General Services (“OGS”) is required to promote opportunities for the maximum feasible participation of New York State-certified Minority- and Women-owned Business Enterprises (“MWBEs”) and the employment of minority group members and women in the performance of OGS contracts.

  • Cancellation of electronic bill notification The electronic Xxxxxx reserves the right to cancel the presentment of electronic bills at any time. You may cancel electronic bill presentment at any time. The timeframe for cancellation of your electronic bill presentment may vary from Xxxxxx to Xxxxxx. It may take up to sixty (60) days, depending on the billing cycle of each Xxxxxx. We will notify your electronic Xxxxxx(s) as to the change in status of your account and it is your sole responsibility to make arrangements for an alternative form of bill delivery. We will not be responsible for presenting any electronic bills that are already in process at the time of cancellation.

  • Electronic invoicing The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Defense Federal Acquisition Regulation Supplement (DFARS) 252.232- 7003, Electronic Submission of Payment Requests and Receiving Reports.

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