MISCELLANEOUS REIMBURSEMENT PROVISIONS Sample Clauses

MISCELLANEOUS REIMBURSEMENT PROVISIONS. 1. Medical Services Entity must submit claims for reimbursement on a CMS-1500 claim form or its successor. 2. Reimbursement shall be made according to Corporation’s reimbursement policies for services including, but not limited to, coding and unbundling, and other billing and reimbursement practices, which are available at xxxxxx.xxx. 3. Notwithstanding any other provision of this Attachment, Corporation may apply to Medical Services Entity’s reimbursement any HSD-directed reimbursement adjustments (whether decreases or increases), including, but in no way limited to, pass throughs, if applicable. 4. References in this Attachment to actions by, or information from, HSD include, but are not necessarily limited to, Chapter 27 of the New Mexico Statutes, Title 8 (Social Services) of the New Mexico Administrative Code, HSD Supplements to MAD NMAC Program Rules (aka, Provider Supplements), HSD Letters of Direction, New Mexico Medicaid Managed Care Services Agreement, and other applicable documented communications from HSD to Managed Care Organizations. 5. Within sixty (60) days of notification from HSD, Corporation shall implement changes to numerical elements of reimbursement calculations described in this Attachment that are based on actions by, or information from, HSD. Corporation reserves the right to determine the effective date of such changes, subject to specific direction by HSD. 6. Corporation may at any time modify the, HCPCS/CPT codes or schedules on which the reimbursement is based to accommodate for new or updated codes. 7. With regard to all reimbursement methodologies described in this Attachment and unless precluded by HSD, Corporation shall pay the lesser of the amount resulting from the applicable reimbursement methodology described in this Attachment or Billed Charges. 8. Member financial responsibility, if any, shall be determined in accordance with the terms of the Member’s Coverage Certificate. The amount of the Member’s financial responsibility, if any, shall be calculated using the lesser of the amount resulting from the applicable reimbursement methodology described in this Attachment or Billed Charges. 9. Corporation shall “zero pay” ($0.00) any Covered Service furnished to a Member by or at the direction of Medical Services Entity that is not addressed by operation of the reimbursement provisions of this or any other reimbursement attachment to the New Mexico Medicaid Managed Care Amendment. 10. Medical Services Entity shall bill Cor...
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Related to MISCELLANEOUS REIMBURSEMENT PROVISIONS

  • Miscellaneous Fees In addition to the Course Fees, the miscellaneous fees set out in Schedule 2.2 may be payable by the Student (the “Miscellaneous Fees”).

  • Miscellaneous Expenses Board members may seek reimbursement for other expenses incurred while attending a meeting sponsored by organizations described herein by fully describing the expenses on the expense form, attaching receipts.

  • Miscellaneous Provisions The following miscellaneous provisions are a part of this Agreement:

  • Miscellaneous Benefits This Agreement is not intended, and shall not be deemed to be in lieu of any rights, benefits, and privileges to which Employee may be entitled as an Employee of Bank under any retirement, pension, profit sharing, insurance, hospital, bonus, vacation, or other plan or plans which may now be in effect or which may hereafter be adopted by Bank, it being understood that Employee shall have the same rights and privileges to participate in such plans and benefits, as any other employee, during the period of his employment.

  • Miscellaneous Charges Miscellaneous Charges apply for the following miscellaneous services when provided with LIS trunks. Exhibit A includes a reference to the Tariff, catalog, price list, or other similar document that provides the amount of each Miscellaneous Charge. 7.3.5.1 Cancellation charges apply to cancelled LIS trunk orders based upon critical dates, terms and conditions in accordance with the Access Service Tariff Section 5.2.3 and trunk nonrecurring charges referenced in this Agreement. 7.3.5.2 Expedite requests for LIS trunk orders are available. Expedites are requests for intervals that are shorter than the interval defined in CenturyLink's Service Interval Guide (SIG) or Individual Case Basis (ICB) Due Dates. When expedites are approved, expedite charges apply per order for every day that the Due Date interval is shortened, based on the standard interval in the SIG or based on ICB criteria for Due Dates. Expedite charges apply to LIS trunk orders based on the rates described in Exhibit A. 7.3.5.2.1 CLEC will request an expedite for LIS trunks, including an expedited Due Date, on the Access Service Request (ASR). 7.3.5.2.2 The request for an expedite will be approved only when resources are available and the request meets the criteria outlined in the Pre- Approved Expedite Process in CenturyLink's Product Catalog at CenturyLink's wholesale web site. 7.3.5.3 Additional testing, including cooperative acceptance testing, automatic scheduled testing, cooperative scheduled testing, manual scheduled testing, and non- scheduled testing, is available for LIS trunks.

  • Miscellaneous Supplemental Fees The Transfer Agent may receive any fees imposed by the Transfer Agent or any affiliate of the Transfer Agent for providing supplemental services to a shareholder pursuant to separate arrangements with the customer, including but not limited to fees for personal advisory services, fees for providing check redemption services, for maintaining and providing services to an individual retirement custodian account, a Xxxxx custodian account, a Prototype Profit Sharing or Money Purchase Pension Plan account or for other similar supplemental services.

  • Miscellaneous Costs 2.1.5.1 Where not included in the General Conditions, and with the prior approval of District, costs of document reproductions (photocopying and blueprinting expenses), long distance telephone call charges, postage, overnight and parcel delivery charges, telephone costs including cellular telephone charges, facsimile or other communication service at the Project site, job photos and progress schedules, and reasonable xxxxx cash expenses of the site office. Developer shall consult with District to determine whether District has any vendor relationships that could reduce the cost of these items and use such vendors whenever possible. 2.1.5.2 Sales, use, gross receipts, local business and similar taxes imposed by a governmental authority that are related to the Work. 2.1.5.3 Fees and assessments for permits, plan checks, licenses and inspections for which Developer is required by the Contract Documents to pay including, but not limited to, permanent utility connection charges, street use permit, street use rental, OSHA permit and sidewalk use permit and fees. 2.1.5.4 Fees of laboratories for tests required by the Contract Documents. 2.1.5.5 Deposits lost for causes other than Developer’s or its subcontractors’ negligence or failure to fulfill a specific responsibility to the District as set forth in the Contract Documents. 2.1.5.6 Expenses incurred in accordance with Developer’s standard personnel policy for relocation and temporary living allowances of personnel required for the Work if approved in advance by District. 2.1.5.7 Where requested by District, costs or expenses incurred by Developer in performing design services for the design-build systems. 2.1.5.8 Other costs incurred in the performance of the Work if, and to the extent, approved in advance by District. 2.1.5.9 Costs due to emergencies incurred in taking action to prevent threatened damage, injury or loss in case of an emergency affecting the safety of persons and/or property. 2.1.5.10 Provided all other eligible costs have been deducted from the contingency and as part of the calculation of amounts due Developer for Final Payment, costs of repairing and correcting damaged or non- conforming Work executed by Developer, Subcontractors or suppliers, providing that such damage or non-conforming Work was not caused by negligence or failure to fulfill a specific responsibility of Developer and only to the extent that the cost of repair or correction is not recovered by Developer from insurance, sureties, Subcontractors or suppliers.

  • MISCELLANEOUS CLAUSES 18.1. No waiver of any right under this Agreement shall be deemed effective unless contained in a written document signed by the Party charged with such waiver, and no waiver of any breach or failure to perform shall be deemed to be a waiver of any other breach or failure to perform or of any other right arising under this Agreement. 18.2. If any provision in this Agreement is agreed by the Parties to be, or is deemed to be, or becomes invalid, illegal, void or unenforceable under any law that is applicable hereto, (i) such provision will be deemed amended to conform to applicable laws so as to be valid and enforceable or, if it cannot be so amended without materially altering the intention of the Parties, it will be deleted, with effect from the date of such agreement or such earlier date as the Parties may agree, and (ii) the validity, legality and enforceability of the remaining provisions of this Agreement shall not be impaired or affected in any way. 18.3. The Parties shall use their respective reasonable endeavours to ensure that the Parties and any necessary Independent Third Party shall do, execute and perform all such further deeds, documents, assurances, acts and things as any of the Parties hereto may reasonably require by notice in writing to the other Party or such Independent Third Party to carry the provisions of this Agreement. 18.4. This Agreement shall be binding upon and enure to the benefit of the Parties hereto, their successors and permitted assigns and sub-licensees. 18.5. No provision of this Agreement shall be construed so as to negate, modify or affect in any way the provisions of any other agreement between the Parties unless specifically referred to, and solely to the extent provided, in any such other agreement. In the event of a conflict between the provisions of this Agreement and the provisions of the Development Agreement, the terms of the Development Agreement shall prevail unless this Agreement specifically provides otherwise. 18.6. No amendment, modification or addition hereto shall be effective or binding on either Party unless set forth in writing and executed by a duly authorised representative of each Party. 18.7. This Agreement may be executed in any number of counterparts, each of which when so executed shall be deemed to be an original and all of which when taken together shall constitute this Agreement. 18.8. Each of the Parties undertake to do all things reasonably within its power which are necessary or desirable to give effect to the spirit and intent of this Agreement. 18.9. Each of the Parties hereby acknowledges that in entering into this Agreement it has not relied on any representation or warranty save as expressly set out herein or in any document referred to herein. 18.10. Nothing contained in this Agreement is intended or is to be construed to constitute Elan and the Company as partners, or Elan as an employee of the Company, or the Company as an employee of Elan. Neither Party hereto shall have any express or implied right or authority to assume or create any obligations on behalf of or in the name of the other Party or to bind the other Party to any contract, agreement or undertaking with any Independent Third Party.

  • Miscellaneous Items Borrower shall deliver to Lender such other items, documents and evidences pertaining to the Line of Credit as may reasonably be requested by Lender.

  • Miscellaneous Terms The term "or" is disjunctive; the term "and" is conjunctive. The term "shall" is mandatory; the term "may" is permissive. Masculine terms also apply to females; feminine terms also apply to males. The term "including" is by way of example and not limitation.

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