Common use of Financial Assistance Calculation, Disbursement, Settlement, & Provider Clause in Contracts

Financial Assistance Calculation, Disbursement, Settlement, & Provider. Audit Procedures (1) OHA will provide financial assistance for A&D 82 Services identified in a particular line of Exhibit C, “Financial Assistance Award,” as specified in the PGS Procedure Codes and Rates for Treatment Providers rate sheet, located at xxxx://xxx.xxxxxxxxx.xxx/treatment/billing-codes-and-rates/, as it may be revised from time to time. (2) Providers of A&D 82 Services shall not charge Individuals whose Services are paid through this Agreement any co-pay or other fees for such Services. (3) Provider Audits: Providers receiving funds under this Agreement, for A&D 82 Services, are subject to audits of all funds applicable to A&D 82 Services rendered. The purpose of these audits is to: (a) Require proper disbursements were made for covered A&D 82 Services; (b) Recover over-payments; (c) Discover any potential or actual instances of fraud and abuse; and (d) Verify that encounter data submissions are documented in the client file, as required and described in the “Special Reporting Requirements” above.