Reimbursement/Claims/Rates Sample Clauses

Reimbursement/Claims/Rates. (a) CMHSP shall reimburse Provider at the rates identified in Attachment B-1: Compensation Schedule (Non-Facility) or Attachment B-2: Compensation Schedule (Facility) for services rendered by Provider that have been authorized by CMHSP and or Administrator as the case may be. Actual payments are subject to Ability to Pay in accordance with Chapter 8 of the Mental Health Code and Chapter 8 of the Michigan Administrative Rules when applicable. (b) For claims payment, CMHSP shall adjudicate or arrange for adjudication and where appropriate make payment for Clean Claims for Covered Services submitted by Provider as follows: (1) 90% or higher for all Clean Claims from network subcontractors within Thirty (30) business days of receipt, and (2) at least 99% of all Clean Claims within Ninety (90) business days of receipt, except services rendered under a subcontract in which other timeliness standards have been specified and agreed upon by both parties (c) CMHSP and Provider shall be responsible for the coordination of public and private benefits for each Covered Person under this Agreement. Provider acknowledges that CMHSP is the payer of last resort. Provider shall be required to identify and seek recovery from all liable first and third parties. Third Party Liability refers to any health insurance or carrier, (e.g., individual, group, employer-related, self-insured, or self- funded plan or commercial carrier, automobile insurance and worker’s compensation) or program (e.g., Medicare) that has liability for all or part of a Covered Person’s covered benefit. (d) Provider may not xxxx Covered Person for the difference between Provider’s charges and CMHSP's or LRE’s rate for Services. Provider shall not seek nor accept additional supplemental payment from the Covered Person, his/her family, or representative in addition to the amount paid by CMHSP. Provider agrees not to maintain any action against a Covered Person to collect sums that are owed to Provider under the terms of this Agreement, even in the event CMHSP fails to pay, becomes insolvent, or otherwise breaches the terms and conditions of this Agreement. This section will survive the termination of this Agreement, regardless of the cause of termination and will be construed to be for the benefit of the Covered Person. (e) For services provided to all Medicaid/SUD Community Grant/PA2/General Fund beneficiaries, Provider’s maximum reimbursement (the sum of first Party, third Party, and CMHSP payments) shall no...
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Reimbursement/Claims/Rates. A. CONTRACTOR shall ensure its accounting procedures and internal financial controls shall conform to generally accepted accounting principles in order that the costs allowed by this Contract, as defined by 2 CFR 200- Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards can be readily ascertained and expenditures verified. Parties understand and acknowledge that their accounting and financial reporting under this Contract must be in compliance with MDHHS’ accounting and reporting requirements.
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Reimbursement/Claims/Rates 
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Related to Reimbursement/Claims/Rates

  • Reimbursement Procedure All claims for reimbursement must be submitted or forwarded to MediCard Head Office within thirty (30) calendar days after discharge from the hospital. Failure to do so shall invalidate the claim, except if it can be shown in writing that it was not reasonably possible to furnish such documents within thirty (30) calendar days. Required documents in availing reimbursement: a. Emergency confinement in non-accredited hospital attended by a non-accredited doctor ▪ Duly filled-up claim form ▪ Clinical Abstract ▪ Medical Certificate to include complete final diagnosis ▪ Surgical/Operative report if an operation was done ▪ Original Official Receipt paid to hospital and doctor ▪ Hospital statement of account and corresponding charge slips ▪ Police report if due to accident or medico-legal case ▪ Incident report why MEMBER was confined in a non-accredited hospital b. Emergency confinement in an accredited hospital attended to by a non-accredited doctor ▪ Duly filled-up claim form ▪ Clinical Abstract ▪ Medical Certificate to include complete final diagnosis ▪ Original Official Receipt paid to the hospital and doctor ▪ Hospital statement of account and corresponding charge slips ▪ Police report if due to accident or medico-legal case ▪ Incident report or proof that MediCard accredited doctor was not available during the time of confinement c. Out-Patient emergency consultation/treatment by a non-accredited doctor in areas where there are accredited hospitals/clinics. ▪ Medical Certificate to include complete final diagnosis ▪ Original Official Receipt paid to the doctor ▪ Incident report ▪ Police report if due to accident or medico-legal case d. Out-Patient emergency or non-emergency consultation/treatment by a non- accredited doctor in areas where there is no accredited Hospital/Clinic. ▪ Medical Certificate to include complete final diagnosis ▪ Original Official Receipt ▪ Incident report ▪ Police report if due to accident or medico-legal case

  • Reimbursement Procedures An employee must keep a record of each trip made. Reimbursement shall be for the actual mileage driven in the performance of assigned duties as verified by the appropriate school district administrator and in accordance with School District Business Office policies and procedures.

  • Compensation, Reimbursement and Indemnification (a) The Company shall pay to the Trustee, and the Trustee shall be entitled to be paid, such compensation, which shall not be limited by any provision of law in regard to the compensation of a trustee of an express trust, as the Company and the Trustee from time to time may agree in writing, for all services rendered by it in the execution of the trusts hereby created and in the exercise and performance of any of the powers and duties hereunder of the Trustee (which compensation will not be limited by any provision of law in regard to the compensation of a trustee of an express trust). Except as otherwise expressly provided herein, the Company will pay or reimburse the Trustee upon its request for all reasonable expenses and disbursements incurred or made by the Trustee in accordance with any of the provisions of this Indenture, including such compensation as has been agreed between the Trustee and the Company from time to time and the expenses and disbursements of its agents, counsel and of all Persons not regularly in its employ, except any such expense or disbursement as may arise from its own negligence or willful misconduct. The Company shall indemnify the Trustee or any predecessor Trustee (and their officers, agents, directors and employees) for, and shall hold them harmless against, any and all loss, liability, claim, damage or expense, including taxes, other than taxes based upon, measured by or determined by the income of the Trustee, reasonably incurred by the Trustee without negligence or willful misconduct on its part and arising out of or in connection with the acceptance or administration or enforcement of this trust, including the reasonable costs and expenses of defending itself against any claim of liability whether asserted by the Company, a Guarantor, any Holder or any other Person. (b) The obligations of the Company under this Section 7.06 to compensate and indemnify the Trustee and to pay or reimburse the Trustee for expenses and disbursements shall: (i) be secured by a lien prior to that of the Securities upon all property and funds held or collected by the Trustee as such, except funds held in trust for the benefit of the holders of particular Securities; and (ii) survive the termination of this Indenture and resignation or removal of the Trustee. (c) Where the Trustee incurs expenses or renders services in connection with a bankruptcy event of default, such costs and expenses (including reasonable attorneys’ fees and expenses) and the compensation for the services are intended to constitute expenses of administration under applicable Federal or State, bankruptcy, insolvency or other law.

  • Meal Reimbursement When an employee is specifically directed by the City to work two (2) hours or longer at the beginning or end of their normal work shift away from their place of residence of at least eight (8) hours or work two (2) hours or longer at the end of their work shift of at least eight (8) hours when the employee is called in to work on their regular day off, or otherwise works under circumstances for which meal reimbursement is authorized per Ordinance 111768 and the employee actually purchases a reasonably priced meal away from his place of residence as a result of such additional hours of work, the employee shall be reimbursed for the "reasonable cost" of such meal in accordance with Seattle Municipal Code (SMC) 4.20.

  • Reimbursement of Costs City may reimburse Consultant’s out-of-pocket costs incurred by Consultant in the performance of the Required Services if negotiated in advance and included in Exhibit A. Unless specifically provided in Exhibit A, Consultant shall be responsible for any and all out-of-pocket costs incurred by Consultant in the performance of the Required Services.

  • Compensation; Reimbursement At the closing of each Offering (each, a “Closing”), the Company shall compensate Xxxxxxxxxx as follows:

  • REIMBURSEMENT OF FEES AND COSTS The Parties acknowledge that Xxxxxxx and her counsel offered to reach preliminary agreement on the material terms of this dispute before reaching terms on the amount of fees and costs to be reimbursed to them. The Parties thereafter reached an accord on the compensation due to Xxxxxxx and her counsel under general contract principles and the private attorney general doctrine and principles codified at California Code of Civil Procedure § 1021.5, for all work performed through the mutual execution of this agreement. Under these legal principles, ABG shall reimburse Xxxxxxx’s counsel for fees and costs incurred as a result of investigating and bringing this matter to ABG’s attention, and negotiating a settlement in the public interest. Within ten (10) days of the Effective Date, ABG shall issue a check payable to “Xxxxxxx & Xxxxx” in the amount of $4,500.00 for delivery to the address identified in § 3.2(a)(i), above.

  • Compensation; Reimbursement; Indemnity (a) The Company agrees: (i) to pay to the Trustee from time to time reasonable compensation for all services rendered by it hereunder in such amounts as the Company and the Trustee shall agree from time to time (which compensation shall not be limited by any provision of law in regard to the compensation of a trustee of an express trust); (ii) to reimburse the Trustee upon its request for all reasonable expenses, disbursements and advances incurred or made by the Trustee in accordance with any provision of this Indenture (including the reasonable compensation and the expenses and disbursements of its agents and counsel), except any such expense, disbursement or advance as may be attributable to its negligence, bad faith or willful misconduct; and (iii) to the fullest extent permitted by applicable law, to indemnify the Trustee and its Affiliates, and their officers, directors, shareholders, agents, representatives and employees for, and to hold them harmless against, any loss, damage, liability, tax (other than income, franchise or other taxes imposed on amounts paid pursuant to (i) or (ii) hereof), penalty, expense or claim of any kind or nature whatsoever incurred without negligence, bad faith or willful misconduct on its part arising out of or in connection with the acceptance or administration of this trust or the performance of the Trustee’s duties hereunder, including the costs and expenses of defending itself against any claim or liability in connection with the exercise or performance of any of its powers or duties hereunder. (b) To secure the Company’s payment obligations in this Section 6.6, the Company hereby grants and pledges to the Trustee and the Trustee shall have a lien prior to the Securities on all money or property held or collected by the Trustee, other than money or property held in trust to pay principal and interest on particular Securities. Such lien shall survive the satisfaction and discharge of this Indenture or the resignation or removal of the Trustee. (c) The obligations of the Company under this Section 6.6 shall survive the satisfaction and discharge of this Indenture and the earlier resignation or removal of the Trustee. (d) In no event shall the Trustee be liable for any indirect, special, punitive or consequential loss or damage of any kind whatsoever, including, but not limited to, lost profits, even if the Trustee has been advised of the likelihood of such loss or damage and regardless of the form of action. (e) In no event shall the Trustee be liable for any failure or delay in the performance of its obligations hereunder because of circumstances beyond its control, including, but not limited to, acts of God, flood, war (whether declared or undeclared), terrorism, fire, riot, embargo, government action, including any laws, ordinances, regulations, governmental action or the like which delay, restrict or prohibit the providing of the services contemplated by this Indenture.

  • Reimbursement of Underwriters’ Expenses If the sale of the Securities provided for herein is not consummated because any condition to the obligations of the Underwriters set forth in Section 5 hereof is not satisfied, because of any termination pursuant to Section 9 hereof or because of any refusal, inability or failure on the part of the Company to perform any agreement herein or comply with any provision hereof other than by reason of a default by any of the Underwriters, the Company will reimburse the Underwriters severally upon demand for all out-of-pocket expenses (including reasonable fees and disbursements of counsel) that shall have been incurred by them in connection with the proposed purchase and sale of the Securities.

  • Reimbursement of Eligible Costs To be eligible for reimbursement, the Engineer's costs must (1) be incurred in accordance with the terms of a valid work authorization; (2) be in accordance with Attachment E, Fee Schedule; and (3) comply with cost principles set forth at 48 CFR Part 31, Federal Acquisition Regulation (FAR 31). Satisfactory progress of work shall be maintained as a condition of payment.

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