Payment to Providers Sample Clauses

Payment to Providers. Alliant will assure that every Provider or facility that treats Members will seek reimbursement from Alliant and not from a Member or the Employer, except with respect to Co- Payment/Co-Insurance and other costs and expenses that are required to be paid by Member directly to Provider pursuant to the Certificate of Coverage.
Sample 1Sample 2
AutoNDA by SimpleDocs
Payment to Providers. CompCare is solely responsible for payment for MHSA Services provided to Members. In the event CompCare fails to pay CompCare Providers or non-CompCare Providers who furnish covered MHSA Services, Health Plans may, after written notice to CompCare and only after such CompCare Provider or non-CompCare Provider has exhausted its remedies under the appeals process set forth in CompCare’s agreement with such CompCare Provider and CompCare’s policies and procedures (in the case of non-CompCare Providers), make payments to such providers on behalf of CompCare; provided that if a provider attempts to collect from a Member, Health Plans may make payment without waiting for exhaustion of CompCare’s appeals process. In such case, Health Plans shall submit an itemized list of such payments to CompCare, and Health Plans shall deduct from CompCare’s future Capitation payment(s) (with the timing of such deductions and the element of the Capitation from which the deduction is made being at Health Plans’ sole discretion) an amount equal to such payments. CompCare hereby agrees to defend and hold harmless Health Plans from any claims for payment by CompCare Providers or non-CompCare Providers for Covered Services rendered to Members that are contemplated as the responsibility of CompCare under this Agreement.
Sample 1Sample 2
Payment to Providers. 1.8.1 In Network Providers (Participating Providers). For In-Network Covered Services, the Participating Provider will bill the Health Plan directly for the services. You do not have to file any claims for these services. You are responsible for payment of:
Sample 1
Payment to Providers. BJC shall be solely financially responsible for the compensation remitted to BJC Providers and Participating Providers for all Covered Services rendered to BJC Members whether provided in or outside of Plan's Service Areas and BJC's Service Sites. BJC shall and shall ensure that BJC Providers hold harmless and indemnify Plan and Payor against any claims for compensation by a BJC Provider. BJC shall hold harmless and indemnify Plan and Payor against any claims for compensation by a Participating Provider for Covered Services for which GHP has made payment to BJC out of the Claims Payment Account. BJC shall and shall assure that Providers provide Plan with Referral Authorizations and other information required for Plan to process and reconcile claims presented for payment by Providers within no later than 60 days from the date of service. Failure to submit claims within 90 days of the date of service or inpatient discharge may result in BJC and BJC Providers forfeiting the right to payment for such claims (member protection provisions in Section 5 below apply). The process by which BJC Providers and Participating Providers are paid shall comply with the terms and conditions set forth in this Agreement (including without limitation Section 3.4 and Section 3.1) and in EXHIBIT A-1, XXX X-0, X-0, XXX X-0.
Sample 1
Payment to Providers. Claims will be processed and adjudicated based on the terms and conditions contracted with each Participating Pharmacy by Xxxxx or Xxxxx’x designated network subcontractor.
Sample 1
Payment to Providers. Company shall be solely responsible for compensating Providers for all Health Services rendered to Members, and Company and Providers shall hold harmless and indemnify Plan and Payor against any claims for compensation by a Provider for Health Services. The method and amount of compensation to Provider shall be set forth in the Participation Agreement. 5 The information below marked by * and [] has been omitted pursuant to a request for confidential treatment. The omitted portion has been separately filed with the Commission.
Sample 1
Payment to Providers. The Participant, or their Representative/Nominee accepts ultimate responsibility for selecting who will provide other support services and advising 101 Plan Management who those providers are, their contact details and the Service Agreements or arrangements you have with them. 101 Plan Management encourages Participants to provide a copy of any agreements with other providers to 101 Plan Management to assist in the budgeting and management of their NDIS Plan. The Providers that 101 Plan Management will make payment to are detailed as outlined in a Service Support Report, Service Provider Category Budget, Consent to Exchange or as otherwise advised throughout the period of this Service Agreement. This is a list of the Providers you have asked us to pay to provide supports under your NDIS Plan which may include amounts that we will pay to these Providers under the NDIS Plan and in accordance with the NDIA Price Guide. 101 Plan Management is not responsible for any outstanding invoices that are unable to be processed and/or claimed whereby there is insufficient funds or funds are exhausted.
Sample 1
AutoNDA by SimpleDocs
Payment to Providers. The Participant, or their Representative/Nominee, accepts ultimate responsibility for selecting who will provide other support services and advising 101 Plan Management who those providers are, their contact details and the Service Agreements or arrangements you have with them. 101 Plan Management encourages Participants to provide a copy of any agreements with other providers to 101 Plan Management to assist in the budgeting and management of their NDIS Plan. The Providers that 101 Plan Management will make payment to are detailed as outlined in a Service Support Report, Service Provider Category Budget, Consent to Exchange or as otherwise advised throughout the period of this Service Agreement. This is a list of the Providers you have asked us to pay to provide supports under your NDIS Plan which may include amounts that we will pay to these Providers under the NDIS Plan and in accordance with the NDIA Price Guide. The Participant, or their Representative/Nominee, consents to invoices being processed and claimed on their behalf upon receipt of compliant invoices. 101 Plan Management is not responsible for any outstanding invoices that are unable to be processed and/or claimed whereby there is insufficient funds or funds are exhausted.
Sample 1
Payment to Providers 
Sample 1Sample 2Sample 3See All (4)

Related to Payment to Providers

  • Agreement to Provide Information Intermediary agrees to provide the Fund, upon written request, the taxpayer identification number (“TIN”), the Individual Taxpayer Identification Number (“ITIN”), or other government-issued identifier (“GII”), if known, of any or all Shareholder(s) of the account and the amount, date, name or other identifier of any investment professional(s) associated with the Shareholder(s) or account (if known), and transaction type (purchase, redemption, transfer, or exchange) of every purchase, redemption, transfer, or exchange of Shares held through each account maintained by the Intermediary during the period covered by the request.

  • Failure to Provide Insurance Lessee acknowledges that any failure on its part to obtain or maintain the insurance required herein will expose Lessor to risks and potentially cause Lessor to incur costs not contemplated by this Lease, the extent of which will be extremely difficult to ascertain. Accordingly, for any month or portion thereof that Lessee does not maintain the required insurance and/or does not provide Lessor with the required binders or certificates evidencing the existence of the required insurance, the Base Rent shall be automatically increased, without any requirement for notice to Lessee, by an amount equal to 10% of the then existing Base Rent or $100, whichever is greater. The parties agree that such increase in Base Rent represents fair and reasonable compensation for the additional risk/costs that Lessor will incur by reason of Lessee's failure to maintain the required insurance. Such increase in Base Rent shall in no event constitute a waiver of Lessee's Default or Breach with respect to the failure to maintain such insurance, prevent the exercise of any of the other rights and remedies granted hereunder, nor relieve Lessee of its obligation to maintain the insurance specified in this Lease.

  • Providers Services performed by a provider who has been excluded or debarred from participation in federal programs, such as Medicare and Medicaid. To determine whether a provider has been excluded from a federal program, visit the U.S. Department of Human Services Office of Inspector General website (xxxxx://xxxxxxxxxx.xxx.xxx.xxx/) or the Excluded Parties List System website maintained by the U.S. General Services Administration (xxxxx://xxx.xxx.gov/). • Services provided by facilities, dentists, physicians, surgeons, or other providers who are not legally qualified or licensed, according to relevant sections of Rhode Island Law or other governing bodies, or who have not met our credentialing requirements. • Services provided by a non-network provider, unless listed as covered in the Summary of Medical Benefits. • Services provided by naturopaths, homeopaths, or Christian Science practitioners.

  • Third Party Providers Except for those terms and conditions that specifically apply to Third Party Providers, under no circumstances shall any other person be considered a third party beneficiary of this Agreement or otherwise entitled to any rights or remedies under this Agreement. Except as may be provided in Third Party Agreements, Company shall have no rights or remedies against Third Party Providers, Third Party Providers shall have no liability of any nature to the Company, and the aggregate cumulative liability of all Third Party Providers to the Company shall be $1.

  • Third Party Service Providers Unless otherwise prohibited by Apple in the Documentation or this Agreement, You are permitted to employ or retain a third party (“Service Provider”) to assist You in using the Apple Software and Services provided pursuant to this Agreement, including, but not limited to, engaging any such Service Provider to maintain and administer Your Applications’ servers on Your behalf, provided that any such Service Provider’s use of the Apple Software and Services or any materials associated therewith is done solely on Your behalf and only in accordance with these terms. Notwithstanding the foregoing, You may not use a Service Provider to submit an Application to the App Store or use TestFlight on Your behalf. You agree to have a binding written agreement with Your Service Provider with terms at least as restrictive and protective of Apple as those set forth herein. Any actions undertaken by any such Service Provider in relation to Your Applications or use of the Apple Software or Apple Services and/or arising out of this Agreement shall be deemed to have been taken by You, and You (in addition to the Service Provider) shall be responsible to Apple for all such actions (or any inactions). In the event of any actions or inactions by the Service Provider that would constitute a violation of this Agreement or otherwise cause any harm, Apple reserves the right to require You to cease using such Service Provider.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!