FUNDING AND PAYMENTS. 2 A. COUNTY shall pay the Intermediary an amount sufficient to reimburse Hospital Claims in 3 accordance with Exhibit B to this Agreement. 4 1. Payment by the Intermediary to CONTRACTOR for Hospital Services shall be contingent 5 upon ADMINISTRATOR’s receipt or confirmation of receipt of a fully executed Agreement and Rate 6 Certification Form from CONTRACTOR in accordance with Paragraph III.B of this Exhibit A to the 7 Agreement for Period One. Payment by the Intermediary to CONTRACTOR for Period Two, Period 8 Three, Period Four, and Period Five shall be contingent upon receipt of an updated Rate Certification 9 Form in accordance with subaragraph VI.B of Exhibit B to this Agreement. 10 2. Any Hospital that does not become a Contracting ED Hospital or Contracting Network 11 Hospital and elects to provide any Hospital Services to any MSN Enrollee shall be reimbursed by 12 COUNTY at the Non-Contract Hospital rates. 13 B. Sub-Acute Services – COUNTY shall pay the Intermediary the amount necessary to cover 14 reimbursement for Sub-Acute Services in accordance with letter(s) of agreement as may be negotiated 15 by ADMINISTRATOR for such services. These services may include, but are not limited to, Sub-Acute 16 and Skilled Nursing Facility Services. 17 C. Special Permit Transfer – COUNTY shall pay Intermediary the amount necessary to cover 18 reimbursement for Special Permit Transfer Services as allowed in subparagraph III.K.12 of this Exhibit 19 A to the Agreement. This Agreement shall not obligate CONTRACTOR to accept a transfer from, nor 20 to provide compensation to, any other health care facility, subject to requirements of applicable law. 21 D. COUNTY shall not reimburse CONTRACTOR for services provided to Transfer Patients. 22 E. ADMINISTRATOR may withhold or delay any payment due CONTRACTOR for failure to 23 comply with any of the terms of this Agreement. 24 F. CONTRACTOR and ADMINISTRATOR may mutually agree, in writing, to modify the 25 Funding and Payment Paragraph of this Exhibit A to the Agreement. 26
Appears in 1 contract
Samples: Medical Services Agreement
FUNDING AND PAYMENTS. 2 30 A. COUNTY shall pay the Intermediary an amount sufficient to reimburse Hospital Claims in 3 31 accordance with Exhibit B to this AgreementContract.
4 32 1. Payment by the Intermediary to CONTRACTOR for Hospital Services shall be contingent 5 33 upon ADMINISTRATOR’s receipt or confirmation of receipt of a fully executed Agreement Contract and Rate 6 34 Certification Form from CONTRACTOR in accordance with Paragraph III.B VI.B of this Exhibit A B to the 7 Agreement Contract 35 for Period One. Payment by the Intermediary to CONTRACTOR for Period Two, Period 8 Three, Period Four, and Period Five Three shall 36 be contingent upon receipt of an updated Rate Certification 9 Form in accordance with subaragraph subparagraph VI.B 37 of Exhibit B to this AgreementContract.
10 1 2. Any Hospital that does not become a Contracting ED Hospital or Contracting Network 11 2 Hospital and elects to provide any Hospital Services to any MSN Enrollee shall be reimbursed by 12 3 COUNTY at the Non-Contract Hospital rates.
13 4 B. Sub-Acute Services – COUNTY shall pay the Intermediary the amount necessary to cover 14 5 reimbursement for Sub-Acute Services in accordance with letter(s) of agreement as may be negotiated 15 by 6 ADMINISTRATOR for such services. These services may include, but are not limited to, Sub-Acute 16 and 7 Skilled Nursing Facility Services.
17 8 C. Special Permit Transfer – COUNTY shall pay Intermediary the amount necessary to cover 18 9 reimbursement for Special Permit Transfer Services as allowed in subparagraph III.K.12 of this Exhibit 19 10 A to the AgreementContract. This Agreement Contract shall not obligate CONTRACTOR to accept a transfer from, nor 20 to 11 provide compensation to, any other health care facility, subject to requirements of applicable law.
21 12 D. COUNTY shall not reimburse CONTRACTOR for services provided to Transfer Patients.
22 13 E. ADMINISTRATOR may withhold or delay any payment due CONTRACTOR for failure to 23 14 comply with any of the terms of this AgreementContract.
24 15 F. CONTRACTOR and ADMINISTRATOR may mutually agree, in writing, to modify the 25 Funding 16 and Payment Payments Paragraph of this Exhibit A to the Agreement. 2617
Appears in 1 contract
FUNDING AND PAYMENTS. 2 A. COUNTY shall pay the Intermediary an amount sufficient to reimburse Hospital Claims in 3 accordance with Exhibit B to this AgreementContract.
4 1. Payment by the Intermediary to CONTRACTOR for Hospital Services shall be contingent 5 upon ADMINISTRATOR’s receipt or confirmation of receipt of a fully executed Agreement Contract and Rate 6 Certification Form from CONTRACTOR in accordance with Paragraph III.B VI.B of this Exhibit A B to the Contract 7 Agreement for Period One. Payment by the Intermediary to CONTRACTOR for Period Two, Period 8 Three, Period Four, and Period Five Three shall 8 be contingent upon receipt of an updated Rate Certification 9 Form in accordance with subaragraph subparagraph VI.B 9 of Exhibit B to this AgreementContract.
10 2. Any Hospital that does not become a Contracting ED Hospital or Contracting Network 11 Hospital and 11 elects to provide any Hospital Services to any MSN Enrollee shall be reimbursed by 12 COUNTY at the 12 Non-Contract Hospital rates.
13 B. Sub-Acute Services – COUNTY shall pay the Intermediary the amount necessary to cover 14 reimbursement for Sub-Acute Services in accordance with letter(s) of agreement contract as may be negotiated by 15 by ADMINISTRATOR for such services. These services may include, but are not limited to, Sub-Acute and 16 and Skilled Nursing Facility Services.
17 C. Special Permit Transfer – COUNTY shall pay Intermediary the amount necessary to cover 18 reimbursement for Special Permit Transfer Services as allowed in subparagraph III.K.12 Paragraph III.C.12 of this Exhibit 19 A to 19 the AgreementContract. This Agreement Contract shall not obligate CONTRACTOR to accept a transfer from, nor 20 to provide 20 compensation to, any other health care facility, subject to requirements of applicable law.
21 D. COUNTY shall not reimburse CONTRACTOR for services provided to Transfer Patients.
22 E. ADMINISTRATOR may withhold or delay any payment due CONTRACTOR for failure to 23 comply with any of the terms of this AgreementContract.
24 F. CONTRACTOR and ADMINISTRATOR may mutually agree, in writing, to modify the Funding 25 Funding and Payment Payments Paragraph of this Exhibit A to the AgreementContract. 26
Appears in 1 contract
Samples: Contract for Provision of Emergency and Stabilization Hospital Services
FUNDING AND PAYMENTS. 2 5 A. COUNTY shall pay the Intermediary an amount sufficient to reimburse Hospital Claims in 3 6 accordance with Exhibit B to this Agreement.
4 7 1. Payment by the Intermediary to CONTRACTOR for Hospital Services shall be contingent 5 8 upon ADMINISTRATOR’s receipt or confirmation of receipt of a fully executed Agreement and Rate 6 9 Certification Form from CONTRACTOR in accordance with Paragraph III.B of this Exhibit A to the 7 this 10 Agreement for Period One. Payment by the Intermediary to CONTRACTOR for Period Two, Period 8 11 Three, Period Four, and Period Five shall be contingent upon receipt of an updated Rate Certification 9 12 Form in accordance with subaragraph Paragraph VI.B of Exhibit B to this Agreement.
10 13 2. Any Hospital that does not become a Contracting ED Hospital or Contracting Network 11 Hospital and 14 elects to provide any Hospital Services to any MSN Enrollee shall be reimbursed by 12 COUNTY at the 15 Non-Contract Hospital rates.
13 16 B. Sub-Acute Services – COUNTY shall pay the Intermediary the amount necessary to cover 14 17 reimbursement for Sub-Acute Services in accordance with letter(s) of agreement as may be negotiated 15 18 by ADMINISTRATOR for such services. These services may include, but are not limited to, Sub-Acute 16 19 and Skilled Nursing Facility Services.
17 20 C. Special Permit Transfer – COUNTY shall pay Intermediary the amount necessary to cover 18 21 reimbursement for Special Permit Transfer Services as allowed in subparagraph III.K.12 Paragraph III.C.12 of this Exhibit 19 A to 22 the Agreement. This Agreement shall not obligate CONTRACTOR to accept a transfer from, nor 20 to 23 provide compensation to, any other health care facility, subject to requirements of applicable law.
21 24 D. COUNTY shall not reimburse CONTRACTOR for services provided to Transfer Patients.
22 25 E. ADMINISTRATOR may withhold or delay any payment due CONTRACTOR for failure to 23 26 comply with any of the terms of this Agreement.
24 27 F. CONTRACTOR and ADMINISTRATOR may mutually agree, in writing, to modify the 25 28 Funding and Payment Paragraph of this Exhibit A to the Agreement. 2629
Appears in 1 contract
Samples: Agreement for Provision of Emergency and Stabilization Hospital Services