Payment to Provider. The RDAR contractor will be paid a boarding fee for each trip and for each revenue mile or group trip operated, less the fares to be collected. The contractor will also be paid or assessed additional amounts based on the contractor achieving or failing to achieve levels of performance set forth in the contract. Each jurisdiction will pay all boarding fees, per-mile charges, group charges and retain all fares for trips taken by its residents. All costs associated with incentives and all savings associated with penalties will be apportioned to each jurisdiction based on its pro rata share of service.
Payment to Provider. The school district agrees to pay the provider the amount indicated per child for each session of instruction provided for, up to a maximum payment of what is allowable by law.
Payment to Provider. The school district agrees to pay the provider the amount indicated per child for each session of instruction provided for, up to a maximum payment of what is allowable by law. a. Rate Per Child (est’d by CDE)* b. Session Length In Minutes c. No. of Weekly Sessions d. Cost per Sessions e. Total Cost per Pupil (Item c x d.)
Payment to Provider. A. The Department shall pay the Provider based on established rates and service units provided to each client, in accordance with listed exceptions, limitations and APRA authorizations, for each billing code listed in the following schedule.
(1) Recovery Support Service (RSS) Type and Description (2) Billing Code (3) One Billable Service Unit Equals (4) Rate per Service Unit (5) Required Exceptions and Limitations - per RSS, per Client Authorizations may be required from APRA
(1) Recovery Support Service (RSS) Type and Description (2) Billing Code (3) One Billable Service Unit Equals (4) Rate per Service Unit (5) Required Exceptions and Limitations - per RSS, per Client Authorizations may be required from APRA
Payment to Provider. A. The Department shall reimburse providers for services to Medicaid beneficiaries in accordance with the State Plan or any applicable waiver from the State Plan.
B. The provider shall submit claims for payment according to the Department’s requirements.
C. The provider shall furnish to the Department its National Provider Identifier (NPI) and include the NPI on all claims submitted to the Department.
D. The Department shall make payments to the provider in accordance with applicable laws, as promptly as is feasible after a proper claim is submitted and approved.
E. The Department shall notify the provider of any major changes in Title XIX rules and regulations and in the State Plan. Publication in the D.C. Register may satisfy this notice requirement.
F. The provider shall not xxxx the beneficiary for any part of care or treatment.
Payment to Provider. Communication Therapy, or its designee, shall pay You as set forth in Addendum A, as may be amended from time to time. You acknowledge and agree that our primary concern is attaining the highest quality of care. Poor documentation places Us in financial hardship and creates poor quality of care. As such, you fully and voluntarily acknowledge and agree that Communication Therapy may impose a penalty for failure of You to timely and/or completely finalize and return any requested documentation. Any penalty will be at the sole discretion of Us, including, but not limited to, a withholding of your fee in the amount of the unbilled charges, a per patient revenue charge for each untimely or incomplete chart, or other penalty amount(s).
Payment to Provider. The broker will be paid on a monthly fixed fee, cost per revenue mile and a surcharge for every wheelchair boarding of city residents. All fares will be kept by the broker but remain the property of RPTA and serve to offset expenses.
Payment to Provider. A. TriWest will make best efforts to process Clean Claims within thirty (30) days of receipt and will make payment directly to Provider for Covered Services rendered by Provider to Beneficiaries in accordance with the terms of the Reimbursement Exhibit. Provider understands and agrees that TriWest is not the insurer, guarantor or underwriter of the payment of benefits to Provider for government health programs administered by TriWest.
B. All services must be authorized, Medically Necessary and provided at an appropriate level of care. Provider must comply with applicable TriWest utilization review/payment management programs and procedures. TriWest may utilize a standard industry code review system in adjudicating claims and determining appropriate levels of coding.
C. Provider understands and agrees that there may be payment adjustments, including retroactive adjustments, through the remittance or return of underpayments, overpayments, recoupments and adjustments for retroactive terminations or denials of coverage and claims payment determinations.
Payment to Provider. Valley Metro’s EVDAR contractor will be paid a fixed monthly fee and on the basis of revenue miles operated with an additional surcharge for each trip requiring the use of a ramp or lift-equipped vehicle. Wheelchair surcharges will not be charged to the City except for trips provided to ADA certified individuals who use mobility devices and who require the use of a lift/ramp equipped vehicle) All passenger fares will be retained by the contractor as a partial offset to these expenses. The contractor will only be reimbursed for revenue miles traveled by EVDAR riders. There is no additional compensation for Personal Care Attendants and companions traveling with EVDAR riders. Furthermore, there is no compensation for the second and subsequent riders being transported simultaneously within the same EVDAR vehicle. Valley Metro has established performance-based incentives and disincentives which may add to or deduct from the amounts which would otherwise be due to the EVDAR contractor. These performance-based incentives and disincentives will be applied for exceptionally good or poor performance in the areas of trip-sharing, on-time performance, customer satisfaction, system safety and adherence to other contractual requirements. The value of these incentives or disincentives will be applied to each participating City based on its relative share of EVDAR service operated.
Payment to Provider. A. The Department shall pay the Provider based on established rates and service units provided to each client, in accordance with listed exceptions, limitations and APRA authorizations, for each Healthcare Common Procedural Coding System (HCPCS) code listed in the following schedule. Only a laboratory certified to be in compliance with the Centers for Medicaid and Medicare Services (CMS) Clinical Laboratory Improvement Amendments of 1988 (CLIA), and under separate contract with APRA, shall be authorized to bill APRA for urinalysis services.
(1) Description of Service / Procedure Code (2) HCPCS CODE (3) One Billable Service Unit Equals (4) Location or Setting (5) Rate per Service Unit (6) Required Exceptions and Limitations - per Procedure, per Client Authorizations required from APRA
a. Non- Hospital- Based Setting b. Hospital- Based Setting
(1) Description of Service / Procedure Code (2) HCPCS CODE (3) One Billable Service Unit Equals (4) Location or Setting (5) Rate per Service Unit (6) Required Exceptions and Limitations - per Procedure, per Client Authorizations required from APRA
a. Non- Hospital- Based Setting b. Hospital- Based Setting
(1) Description of Service / Procedure Code (2) HCPCS CODE (3) One Billable Service Unit Equals (4) Location or Setting (5) Rate per Service Unit (6) Required Exceptions and Limitations - per Procedure, per Client Authorizations required from APRA
a. Non- Hospital- Based Setting b. Hospital- Based Setting
(1) Description of Service / Procedure Code (2) HCPCS CODE (3) One Billable Service Unit Equals (4) Location or Setting (5) Rate per Service Unit (6) Required Exceptions and Limitations - per Procedure, per Client Authorizations required from APRA
a. Non- Hospital- Based Setting b. Hospital- Based Setting
