Provider Refunds Of Claims Covered By Other Payments Sample Clauses

Provider Refunds Of Claims Covered By Other Payments. 8 1. If CONTRACTOR, through its own efforts, identifies Medi-Cal coverage, third party 9 settlement, primary or other insurance coverage for services reimbursed through the Agreement, 10 CONTRACTOR shall, within thirty (30) calendar days of such identification, unless disputed in 11 accordance with subparagraph G.2. below, reimburse the Intermediary an amount equal to the MSN 12 payment. If Medi-Cal coverage, third party settlement, primary or other insurance coverage is identified 13 due to efforts of Intermediary’s Third Party Recovery Services (Recovery Services) specified in 14 subparagraph G.4. below, CONTRACTOR shall, within thirty (30) calendar days of notice from 15 Recovery Services, unless disputed in accordance with subparagraph G.2. below, reimburse the 16 Intermediary an amount equal to the MSN payment. Third-party settlement payments may be paid 17 directly to COUNTY or Intermediary, as directed by ADMINISTRATOR.
Sample 1
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Provider Refunds Of Claims Covered By Other Payments. 10 1. If CLINICCONTRACTOR, through its own efforts, identifies Medi-Cal coverage, third 11 party settlement, primary or other insurance coverage for services reimbursed through the Agreement, 12 CLINICCONTRACTOR shall, within thirty (30) calendar days of such identification, unless disputed in 13 accordance with 14 subparagraph G.2. below, reimburse the Intermediary an amount equal to the MSIMSN payment. If 15 Medi-Cal coverage, third party settlement, primary or other insurance coverage is identified due to 16 efforts of Intermediary’s Third Party Recovery Services (Recovery Services) specified in subparagraph 18 Services, unless disputed in accordance with subparagraph G.2. below, reimburse the Intermediary an 19 amount equal to the MSIMSN payment. Third-party settlement payments may be paid directly to 20 COUNTY or Intermediary, as directed by ADMINISTRATOR.
Sample 1
Provider Refunds Of Claims Covered By Other Payments. 13 1. As allowed in subparagraph II.B. of Exhibit A to the Agreement, if HOSPITAL, through its 14 own efforts, identifies Medi-Cal coverage, any type of third-party settlement, primary coverage or other 15 insurance for services reimbursed through the Agreement, during the term of the Agreement, 16 HOSPITAL shall notify Intermediary of such coverage and provide the corresponding claim information 17 to Intermediary, as directed by Intermediary. Intermediary shall retract the appropriate corresponding 18 Points from HOSPITAL prior to Final Settlement. If Medi-Cal coverage or third-party settlement is 19 identified due to efforts of ADMINISTRATOR’s contracted Third-Party Recovery Agent (Recovery 20 Services) as specified in subparagraph G.5. below, HOSPITAL shall, within thirty (30) days of notice 21 from Recovery Services, unless disputed in accordance with subparagraph G3. below, reimburse an 22 amount equal to the MSI payment. Third-party settlement payments may be paid directly to COUNTY 23 or as specified in subparagraph G.5. below, as directed by ADMINISTRATOR.
Sample 1
Provider Refunds Of Claims Covered By Other Payments. 9 1. Medi-Cal Reimbursement and Third-Party Settlement
Sample 1
Provider Refunds Of Claims Covered By Other Payments. 13 1. As allowed in subparagraph II.B. of Exhibit A to the Agreement, if HOSPITALIf 14 CONTRACTOR, through its own efforts, identifies Medi-Cal coverage, any type of third- party Agreement, during the term of the Agreement, HOSPITAL shall notify CONTRACTOR shall, within thirty (30) calendar days of such identification, unless disputed in accordance with subparagraph G.2. below, reimburse the 15 settlement, primary coverage or other insurance coverage for services reimbursed through the 16 18 Intermediary of such coverage and provide the corresponding claim information to 19 Intermediary, as directed by Intermediary. Intermediary shall retract the appropriate corresponding 20 Points from HOSPITAL prior to Final Settlement. an amount equal to the MSN payment. If Medi-Cal 21 coverage or, third- party settlement, primary or other insurance coverage is identified due to efforts of 22 ADMINISTRATOR’s contractedIntermediary’s Third- Party Recovery AgentServices (Recovery 23 Services) as specified in subparagraph G.54. below, HOSPITALCONTRACTOR shall, within thirty G.2 calendar 24 (30) 25 G3 days of notice from Recovery Services, unless disputed in accordance with subparagraph . below, reimburse the Intermediary an amount equal to the MSIMSN payment. Third-party 26 settlement payments may be paid directly to COUNTY or as specified in subparagraph G.5.
Sample 1

Related to Provider Refunds Of Claims Covered By Other Payments

  • Payment of Claims A. If advance payment of all or a portion of the Grant funds is permitted by statute or regulation, and the State agrees to provide such advance payment, advance payment shall be made only upon submission of a proper claim setting out the intended purposes of those funds. After such funds have been expended, Grantee shall provide State with a reconciliation of those expenditures. Otherwise, all payments shall be made thirty five (35) days in arrears in conformance with State fiscal policies and procedures. As required by IC § 4-13-2-14.8, all payments will be by the direct deposit by electronic funds transfer to the financial institution designated by the Grantee in writing unless a specific waiver has been obtained from the Indiana Auditor of State.

  • RETURNS, CLAIMS, REFUNDS The customer shall immediately upon receipt of goods supplied fully inspect such goods and satisfy itself that the goods are correct. If the customer is unsatisfied, the customer must immediately contact the Company and communicate all details of such dissatisfaction. Unless the above procedure is followed the Company is entitled to assume that the goods supplied are correct and no returns claims for refunds will be permitted or made.

  • Settlement of Claims The Company’s obligation to make the payments provided for in this Agreement and otherwise to perform its obligations hereunder shall not be affected by any circumstances, including, without limitation, any set-off, counterclaim, recoupment, defense or other right which the Company may have against the Executive or others.

  • Claims Payment The Reinsurer will be liable to the Company for its share of the benefits owed under the express contractual terms of the Reinsured Policies and as specified under the terms of this Agreement. The Reinsurer will not participate in any ex gratia payments made by the Company (i.e., payments the Company is not required to make under the Reinsured Policy terms.) The payment of death benefits by the Reinsurer will be in one lump sum regardless of the mode of settlement under the Reinsured Policy. Benefit payments from the Reinsurer will be due within 30 days of the claim satisfying the requirements established under this Agreement. The Reinsurer’s share of any interest payable under the terms of a Reinsured Policy or applicable law which is based on the death benefits paid by the Company, will be payable provided that the Reinsurer will not be liable for interest accruing on or after the date of the Company’s payment of benefits. The Reinsurer will make payment to the Company for each such claim. For Waiver of Premium claims, the Company will continue to pay premiums for reinsurance, except premiums for disability reinsurance. The Reinsurer will pay its proportionate share of the gross premium waived by the Company on the Reinsured Policy, including its share of the premiums for benefits that remain in effect during disability. For claims on Accelerated Benefit riders reinsured under this Agreement, the benefit amount payable by the Reinsurer will be calculated by multiplying the total accelerated death benefit rider payout by the ratio of the reinsured Net Amount at Risk, as defined in Exhibit C-1, to the face amount of the Reinsured Policy.

  • Indemnification for Certain Claims The Party providing services hereunder, its affiliates and its parent company, shall be indemnified, defended and held harmless by the Party receiving services hereunder against any claim, loss or damage arising from the receiving company’s use of the services provided under this Agreement pertaining to (1) claims for libel, slander or invasion of privacy arising from the content of the receiving company’s own communications, or (2) any claim, loss or damage claimed by the End User of the Party receiving services arising from such company’s use or reliance on the providing company’s services, actions, duties, or obligations arising out of this Agreement.

  • Time Limits on Claims Claims by either party must be made within twenty-one (21) days after occurrence of the event giving rise to such Claim or within twenty-one (21) days after the claimant first recognizes the condition giving rise to the Claim, whichever is later. Claims must be made by written notice and include all facts and detailed cost data substantiating the Claim. An additional Claim made after the initial Claim has been implemented by Change Order will not be considered unless submitted in a timely manner.

  • Compensation Claims (a) The Employer agrees to cooperate toward the prompt disposition of employee on-the-job injury claims. The Employer shall provide worker’s compensation protection for all employees even though not required by state law, or the equivalent thereof, if the injury arose out of or in the course of employment. No employee will be disciplined or threatened with discipline as a result of filing an on-the-job injury report. The Employer or its designee shall not visit an injured worker at his/her home, at a hospital or any location outside the employee’s home terminal without his/her consent.

  • NO EXTRA CLAIMS COMMITMENT During the life of this agreement the parties agree and are therefore bound not to pursue any additional claims. It is agreed that up to the nominal expiry date of this agreement:

  • Employer Liability 45.1 The Employer shall indemnify and save harmless all Employees from legal liability and all actions, causes of action, claims or demands whatsoever arising out of any occurrence occurring during the course of or performed pursuant to and within the scope of their employment, save and except in the case of gross negligence or wilful misconduct, provided timely notice is given to the Employer of any occurrence giving rise or likely to give rise to a claim against a member of the Employer.

  • Compensation for Damages 4.1 If the Principal has disqualified the Bidder from the tender process prior to the award according to Section 3, the Principal is entitled to demand and recover the damages equivalent Xxxxxxx Money Deposit/Bid Security.

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