Overpayment Recovery.
A. Except for amounts of $50 or less, when the Agency has determined that an employee has been overpaid, the Employer will provide written notice to the employee, which will include the following items:
1. The amount of the overpayment;
2. The basis for the claim; and
3. The rights of the employee under the terms of this Agreement.
B. Overpayment amounts of fifty dollars ($50) or less will be automatically deducted from the next paycheck.
C. An overpayment amount resulting from an error made by the Employer, as determined by the Chief, shall be limited to the amount of overpayment during the preceding six (6) months prior to the date of correction of the error/overpayment. A supervisor’s signature on an incorrect TAR will not be considered an Employer error.
D. All employees receiving a written notice of overpayment will have the option to dispute the occurrence of an overpayment, and/or dispute the amount of the overpayment, or repay the overpayment.
E. All employees choosing to repay an overpayment in accordance with paragraph F, or who are required to repay an overpayment following resolution of a dispute in accordance with Subsection 23.8 H, will have the option to repay the overpayment over a period of time equal to the number of pay periods during which the overpayment was made, unless a longer period is agreed to by the employee and the Agency. All overpayments will be collected through payroll deduction.
F. The Employer is authorized to deduct the overpayment owed from the employee’s wages beginning with the pay period after an employee has been notified. If an employee files a grievance, overpayment recovery will be suspended until the appeal has been resolved or until separation.
G. Any overpayment amount, regardless of an active appeal/grievance that is still outstanding at separation of employment, will be deducted from an employee’s final pay.
Overpayment Recovery. At XXXXX’ sole discretion, XXXXX may xxxx PROVIDER or Participating Provider for an Overpayment. PROVIDER shall be responsible to remit payment on such an Overpayment invoice within forty-five (45) days from receipt of invoice. Should XXXXX not receive payment within the aforementioned timeframe, XXXXX will, when legally permissible, automatically apply the Overpayment to other outstanding payables on PROVIDER’s account. XXXXX retains the right to seek assistance from various collection agencies and/or to suspend or permanently terminate PROVIDER from further participation in XXXXX’ network in accordance with the suspension and termination provisions set forth in this Agreement. Notwithstanding the foregoing, should this provision conflict with any applicable rules and regulations, said rules and regulations shall govern. Notwithstanding the foregoing, XXXXX’ Overpayment recovery efforts shall comply with any legislative or statutory timeframe(s) specified within the jurisdiction where services were provided.
Overpayment Recovery. If DBI determines that it has paid benefits to an ineligible person or paid more than the appropriate amount, DBI shall, with Employer’s full cooperation, undertake a good faith effort to recover such erroneous payment. For purposes of this provision, DBI shall have the sole discretion to determine what constitutes a “good faith effort,” which effort may vary from time to time depending upon the circumstances of the overpayment, but may include DBI’s attempt to contact the participant twice via letter, phone, email or another means about the recovery of the payment at issue.
Overpayment Recovery. We may recover any overpayment we make for Services from:
Overpayment Recovery. If the City notifies the represented employee of the overpayment before the end of the pay period following the overpayment and gives the represented employee a correct paycheck, the represented employee shall, within five (5) calendar days of receiving the notice of overpayment and the correct paycheck, return to the City the full amount of the overpayment.
Overpayment Recovery. The CHC-MCO shall audit, review and investigate Providers within its Network. The CHC-MCO shall recover any overpayments directly from its Network Providers for audits, reviews or investigations conducted solely by the CHC-MCO. o The CHC-MCO will void Encounters for those claims involving full recovery of the payment and adjust Encounters for partial recoveries. o The CHC-MCO must report all voids and adjustments to Encounters to the Department • The Department may audit, review and investigate MA Providers within the CHC-MCO’s Network. o The Department will develop a process to coordinate audits, reviews or investigations of Network Providers to avoid duplication of effort.
Overpayment Recovery. In accordance with §3224-b of the New York State Insurance Laws, XXXXX may bill PROVIDER or Participating Provider for an Overpayment. PROVIDER shall be responsible to remit payment on such an Overpayment invoice within forty- five (45) days from receipt of invoice. Should XXXXX not receive payment within the aforementioned timeframe, XXXXX will, when legally permissible, apply the Overpayment to other outstanding payables on PROVIDER’s account. XXXXX retains the right to seek assistance from various collection agencies and/or to suspend or permanently terminate PROVIDER from further participation in XXXXX’ network in accordance with the suspension and termination provisions set forth in this Agreement.
Overpayment Recovery. Payor(s). For purposes of this section, "refund" means the return, either directly or through an offset to a future claim, of some or all of a payment already received by a Practitioner.
(1) Except in the case of fraud, or as provided in subsections (2) and (3) of this section, Group and/or WHN may not: (a) Request a refund from Practitioner of a payment previously made to satisfy a claim unless it does so in writing to Practitioner within twenty-four months after the date that the payment was made; or (b) request that a contested refund be paid any sooner than six months after receipt of the request. Any such request must specify why the payor(s) believe(s) Practitioner owes the refund. If Practitioner fails to contest the request in writing to the payor(s) within thirty days of its receipt, the request is deemed accepted and the refund must be paid.
(2) For reasons related to coordination of benefits with another payor or entity responsible for payment of a claim, Group and/or WHN may not: (a) Request a refund from Practitioner of a payment previously made to satisfy a claim unless it does so in writing to Practitioner within thirty months after the date that the payment was made; or (b) request that a contested refund be paid any sooner than six months after receipt of the request. Any such request must specify why the payor(s) believe(s) Practitioner owes the refund, and include the name and mailing address of the entity that has primary responsibility for payment of the claim. If Practitioner fails to contest the request in writing to the payor(s) within thirty days of its receipt, the request is deemed accepted and the refund must be paid.
(3) Group and/or WHN may at any time request a refund from Practitioner of a payment previously made to satisfy a claim if: (a) A third party, including a government entity, is found responsible for satisfaction of the claim as a consequence of liability imposed by law, such as tort liability; and (b) the payor(s) is(are) unable to recover directly from the third party because the third party has either already paid or will pay Practitioner for the health services covered by the claim.
(4) This section does not apply to health care services provided under Title XVIII (Medicare) of the Social Security Act, or Medicare supplemental plans regulated under Revised Code of Washington Chapter 48.66.
Overpayment Recovery. We may recover any overpayment we make for Services from anyone who receives such an overpayment, or from any person or organization obligated to pay for the Services, to the extent that if written authorization, except as described in our Notice of Privacy Practices (see below). Giving us authorization is at your discretion. This is only a brief summary of some of our key privacy practices. Our Notice of Privacy Practices which provides additional information about our privacy practices and your rights regarding your PHI, is available and will be furnished to you upon request. To request a copy, please call our Member Service Call Center (see below). You can also find the notice at your local Plan Facility or on our Web site at xxx.xx.xxx. Inside Washington, D.C., Metropolitan area (000) 000-0000, or in the Baltimore, Maryland TTY (000) 000-0000 Outside the Washington, D.C. Metropolitan area 0-000-000-0000 XXXXXX FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. By: we have made payment to a health care provider, we may only retroactively deny reimbursement to the health care provider during the 6-month period after the date we paid the claim submitted by the health care provider. Privacy Practices Xxxxxx Permanente will protect the privacy of your protected health information (PHI). We also require contracting providers to protect your PHI. Your PHI is individually identifiable information about your health, health care services you receive, or payment for your health care. You may generally see and receive copies of your PHI, correct or update your PHI, and ask us for an accounting of certain disclosures of your PHI. We may use or disclose your PHI for treatment, payment, health research and health care operations purposes, such as measuring the quality of Services. We are sometimes required by law to give PHI to others, such as government agencies or in judicial actions. In addition, Member-identifiable health information is shared with your Group only with your authorization or as otherwise permitted by law. We will not use or disclose your PHI for any other purpose without your (or your representative’s) Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
Overpayment Recovery. A. Except for amounts of $50 or less, when the Agency has determined that an employee has been overpaid, the Employer will provide written notice to the employee, which will include the following items:
1. The amount of the overpayment; 2. The basis for the claim; and
