FAILURE TO TIMELY ADJUDICATE CLAIMS. Failure of HMO to adjudicate (paid, denied, or external pended) at least ninety (90%) of all claims within thirty (30) days of receipt and ninety-nine percent (99%) of all claims within ninety days of receipt for the contract year is a default under this contract.
Appears in 5 contracts
Samples: Star+plus Contract (Amerigroup Corp), Contract for Services (Amerigroup Corp), Contract for Services (Centene Corp)
FAILURE TO TIMELY ADJUDICATE CLAIMS. Failure of HMO to adjudicate (paid, denied, or external pended) at least ninety (90%) of all claims within thirty (30) days of receipt and ninety-nine percent (99%) of all 1999 Renewal Contract Bexar Service Area August 9, 1999 claims within ninety days of receipt for the contract year is a default under this contract.
Appears in 1 contract
Samples: Contract for Services (Centene Corp)
FAILURE TO TIMELY ADJUDICATE CLAIMS. Failure of HMO to adjudicate (paid, denied, or external pended) at least ninety (90%) of all claims within thirty (30) days of receipt and ninety-nine percent (99%) of all claims within ninety (90) days of receipt for the contract year is a default under this contract.
Appears in 1 contract
