Process for Purchaser Provider Appeals Sample Clauses

Process for Purchaser Provider Appeals. If Provider disputes a Purchaser’s payment, non-payment, partial payment, late payment or denial of a claim, Provider may request reconsideration of Purchaser’s action by filing a written appeal with the Purchaser’s Fiscal Department within sixty (60) calendar days of Purchaser’s initial payment/denial notice. The Fiscal Department will review claims for reconsideration when submitted by a Provider under this Contract. Provider appeals information can also be located on Purchaser’s website at: xxxx://xxx.xxxxxxxxxxxxxxx.xxx/providers/claim-appeal-rights/. Appeals from Providers must include the following characteristics:
Sample 1Sample 2Sample 3
AutoNDA by SimpleDocs
Process for Purchaser Provider Appeals. If Provider disputes a Purchaser’s payment, non-payment, partial payment, late payment or denial of a claim, Provider may request reconsideration of Purchaser’s action by filing a written appeal with the Purchaser’s Fiscal Department within sixty (60) calendar days of Purchaser’s initial payment/denial notice. The Fiscal Department will review claims for reconsideration when submitted by a Provider under this Contract. Appeals from Providers must include the following characteristics:
Sample 1

Related to Process for Purchaser Provider Appeals

  • REGULATORY FILINGS AND CAISO TARIFF COMPLIANCE 3.1 Filing

  • Manufacturer's Recommendations All work or materials shall be installed in accordance with the manufacturer's recommendations and requirements. The Contractor shall obtain the manufacturer’s recommendations and requirements, for its use at the Site in executing the Work, copies of bulletins, circulars, catalogues, or other publications bearing the manufacturer’s titles, numbers, editions, dates, etc. If the manufacturer’s recommendations and requirements are not available, the Contractor shall request installation instructions from the Design Professional.

  • Certification for Federal-Aid Contracts Lobbying Activities A. The CONSULTANT certifies, by signing and submitting this Contract, to the best of its knowledge and belief after diligent inquiry, and other than as disclosed in writing to the LPA prior to or contemporaneously with the execution and delivery of this Contract by the CONSULTANT, the CONSULTANT has complied with Section 1352, Title 31, U.S. Code, and specifically, that:

  • Cloud Computing State Risk and Authorization Management Program In accordance with Senate Bill 475, Acts 2021, 87th Leg., R.S., pursuant to Texas Government Code, Section 2054.0593, Contractor acknowledges and agrees that, if providing cloud computing services for System Agency, Contractor must comply with the requirements of the state risk and authorization management program and that System Agency may not enter or renew a contract with Contractor to purchase cloud computing services for the agency that are subject to the state risk and authorization management program unless Contractor demonstrates compliance with program requirements. If providing cloud computing services for System Agency that are subject to the state risk and authorization management program, Contractor certifies it will maintain program compliance and certification throughout the term of the Contract.

  • Required Qualifications for Surety The Contract provides that the surety and insurance companies must be acceptable to the Owner. Only those sureties listed in the Department of Treasury’s Listing of Approved Sureties (Department Circular 570) are acceptable to the Owner. All bonds at the time of issuance must be issued by a company authorized by the Insurance Commissioner to transact the business of suretyship in the State of Georgia, and shall have a Best Policyholders Rating of "A-" or better and with a financial size rating of Class V or larger.

  • Grievance and Appeals Unit See Section 9 for contact information. You may also contact the Office of the Health Insurance Commissioner’s Consumer Resource Program, RIREACH at 1-855-747-3224 about questions or concerns you may have. Complaints A complaint is an expression of dissatisfaction with any aspect of our operation or the quality of care you received from a healthcare provider. A complaint is not an appeal. For information about submitting an appeal, please see the Reconsiderations and Appeals section below. We encourage you to discuss any concerns or issues you may have about any aspect of your medical treatment with the healthcare provider that furnished the care. In most cases, issues can be more easily resolved if they are raised when they occur. However, if you remain dissatisfied or prefer not to take up the issue with your provider, you can call our Customer Service Department for further assistance. You may also call our Customer Service Department if you are dissatisfied with any aspect of our operation. If the concern or issue is not resolved to your satisfaction, you may file a verbal or written complaint with our Grievance and Appeals Unit. We will acknowledge receipt of your complaint or administrative appeal within ten (10) business days. The Grievance and Appeals Unit will conduct a thorough review of your complaint and respond within thirty (30) calendar days of the date it was received. The determination letter will provide you with the rationale for our response as well as information on any possible next steps available to you. When filing a complaint, please provide the following information: • your name, address, member ID number; • the date of the incident or service; • summary of the issue; • any previous contact with BCBSRI concerning the issue; • a brief description of the relief or solution you are seeking; and • additional information such as referral forms, claims, or any other documentation that you would like us to review. Please send all information to the address listed on the Contact Information section.

  • HHS Single Audit Unit will notify Grantee to complete the Single Audit Determination Form If Grantee fails to complete the form within thirty (30) calendar days after receipt of notice, Grantee maybe subject to sanctions and remedies for non-compliance.

  • Shipping must be Freight On Board Destination to the delivery location designated on the Customer purchase order The Contractor will retain title and control of all goods until delivery is completed and the Customer has accepted the delivery. All risk of transportation and all related charges are the responsibility of the Contractor. The Customer will notify the Contractor and H-GAC promptly of any damaged goods and will assist the Contractor in arranging for inspection. The Contractor must file all claims for visible or concealed damage. Unless otherwise stated in the Agreement, deliveries must consist only of new and unused merchandise.

  • Settlement and Recovery of Funding for Prior Years (a) The HSP acknowledges that settlement and recovery of Funding can occur up to 7 years after the provision of Funding.

  • PROCEDURES FOR SUPPLEMENTAL PAYMENT CALCULATIONS All calculations required by this Article VI, including but not limited to: (i) the calculation of the Applicant’s Stipulated Supplemental Payment Amount; (ii) the determination of both the Annual Limit and the Aggregate Limit; (iii) the effect, if any, of the Aggregate Limit upon the actual amount of Supplemental Payments eligible to be paid to the District by the Applicant; and (iv) the carry forward and accumulation of any of the Applicant’s Stipulated Supplemental Payment Amounts unpaid by the Applicant due to the Aggregate Limit in previous years, shall be calculated by the Third Party selected pursuant to Section 4.3.

Time is Money Join Law Insider Premium to draft better contracts faster.