Common use of HEALTH PLAN AND SUBCONTRACTOR REQUIREMENTS Clause in Contracts

HEALTH PLAN AND SUBCONTRACTOR REQUIREMENTS. 4.1 Prompt Payment. Subcontractor or Health Plan (as applicable) shall accept claims electronically by batch file upload or by direct data entry and pay Provider pursuant to the State Contract and applicable State and federal law and regulations, including but not limited to 42 CFR 447.46, 42 CFR 447.45(d)(2), 42 CFR 447.45(d)(3), 42 CFR 447.45(d)(5) and 42 CFR 447.45(d)(6), as applicable and as may be amended from time to time. If a third party liability exists, payment of claims shall be determined in accordance with federal and/or State third party liability law and the terms of the State Contract. Unless Subcontractor or Health Plan (as applicable) otherwise requests assistance from Provider, Subcontractor or Health Plan will be responsible for third party collections in accordance with the terms of the State Contract.