Common use of Our Right to Withhold Payments Clause in Contracts

Our Right to Withhold Payments. We have the right to withhold payment during the period of investigation on any claim we receive that we have reason to believe might not be eligible for coverage. We will also conduct pre-payment review on a claim we have reason to believe has been submitted for a service not covered under this agreement. We will make a final decision on these claims within sixty (60) days after the date you filed said claim. We also have the right to perform post-payment reviews of claims. If we determine misrepresentation was used when you filed the claim, or if we determine that a claim should not have been paid for any reason, we may take all necessary steps (including legal action) to recover funds paid to you or to a provider.

Our Right to Withhold Payments. We have the right to withhold payment during the period of investigation on any claim we receive that we have reason to believe might not be eligible for coverage. We will also conduct pre-payment review on a claim we have reason to believe has been submitted for a service not covered under this agreement. We will make a final decision on these claims within sixty (60) days after the date you filed said the claim. We also have the right to perform post-payment reviews of claims. If we determine misrepresentation was used when you filed the claim, or if we determine conclude that a claim should not have been paid for any reason, we may take all necessary steps (including legal action) to recover funds paid to you or to a providerdentist.

Our Right to Withhold Payments. We have the right to withhold payment during the period of investigation on any claim we receive that we have reason to believe might not be eligible for coverage. We will also conduct pre-payment review on a claim we have reason to believe has been submitted for a service not covered under this agreementplan. We will make a final decision on these claims within sixty (60) days after the date you filed said claim. We also have the right to perform post-payment reviews of claims. If we determine misrepresentation was used when you filed the claim, or if we determine that a claim should not have been paid for any reason, we may take all necessary steps (including legal action) to recover funds paid to you or to a provider.

Our Right to Withhold Payments. We have the right to withhold payment during the period of investigation on any claim we receive that we have reason to believe might not be eligible for coverage. We will also conduct pre-pre- payment review on a claim we have reason to believe has been submitted for a service not covered under this agreement. We will make a final decision on these claims within sixty (60) days after the date you filed said claim. We also have the right to perform post-payment reviews of claims. If we determine misrepresentation was used when you filed the claim, or if we determine that a claim should not have been paid for any reason, we may take all necessary steps (including legal action) to recover funds paid to you or to a provider.

Our Right to Withhold Payments. We have the right to withhold payment during the period of investigation on any claim we receive that we have reason to believe might not be eligible for coverage. We will also conduct pre-payment review on a claim we have reason to believe has been submitted for a service not covered under this agreement. We will make a final decision on these claims within sixty (60) days after the date you filed said the claim. We also have the right to perform post-payment reviews of claims. If we determine misrepresentation was used when you filed the claim, or if we determine conclude that a claim should not have been paid for any reason, we may take all necessary steps (including legal action) to recover funds paid to you or to a provider.