EOBs Sample Clauses

EOBs. In the event that an Originator receives an EOB or a Misdirected Payment in the form of a check, such Originator shall immediately send such Misdirected Payment by overnight delivery service to the appropriate Company Lockbox or Originator Lockbox, as the case may be, together with the EOB and the envelope in which such payment was received. In the event an Originator receives a Misdirected Payment in the form of cash or a wire transfer to an account oth than the Originator Lockbox Account, such Originator shall immediately wire transfer the amount of such Misdirected Payment directly into the Company Lockbox Account. all Misdirected Payments and EOB's shall be sent promptly upon receipt thereof, and in no event later than the close of business, on the first Business Day after receipt thereof.

EOBs. The completed data from the application is then provided to Athena using an agreed data transfer protocol.

EOBs. Patient registration sheet.

EOBs. Letter dated July 29, 2002. The bills in issue represent the charges for MRI scans of the cervical and lumbar spine performed on August 17, 2001 and x-rays of the left elbow, forearm and wrist performed on August 8, 2001. Respondent assessed a $545.00 PPO reduction, a 20% co-payment and a 50% penalty for failure to attempt to pre-certify with regard to the MRI of the lumbar spine. Respondent paid $225.00 towards the provider's charge of $995.00. Respondent assessed a $500.00 PPO reduction and a 20% co-payment to the charge of $995.00 for the cervical spine MRI. Respondent paid $396.00. Respondent also took PPO reductions on the charges for the 3 x-rays and a 20% co- payment. The PPO reduction was $104.42. Respondent paid $88.46 toward the charge of $215.00. Claimant contends that the PPO reductions are invalid in that the CHN agreement between the claimant and CHN does not apply to this claim. First, respondent argues that American Arbitration Association Rules do not permit the DRP to determine the nature and validity of the subject PPO agreement. Rule 3B provides, in pertinent part, that if any party contends that the Association lacks subject matter jurisdiction such party may seek a ruling dismissing the arbitration. The request for dismissal must occur within 45 days after the Demand for Arbitration is filed with the American Arbitration Association. "If no such procedure is initiated, it will be assumed that there is no objection to the Demand for Arbitration." Respondent did not request a Xxxx 3B dismissal based on lack of subject matter jurisdiction. Therefore, I find that respondent has waived the jurisdiction issue. Nevertheless, I do find that the Association's Rules and the case law permit the DRP to decide the validity of the PPO Agreement in this matter. Rule 1 provides that any dispute of substantive law arising out of the application of these administrative rules shall be determined by the DRP. I find that the validity of the PPO Agreement is such a dispute. Further, I direct the parties to State Farm vs. Xxxxxx, 289 N.J. Super 406 (App. Div. 1996) and Xxxxxxxxx vs. General Acc. Ins. Co., 325 N.J. Super 163 (Ch. Div. 1999). The issue of the validity of PPO Agreements in an automobile accident setting has been addressed by other arbitrators and the Courts. There is a divergence of opinions. The Appellate Division has not decided the issue. I find that the CHN Agreement is in violation of the New Jersey PIP Statute and the administrative code...