Common use of Return of Overpayments Clause in Contracts

Return of Overpayments. Under the BlueCard Program, recoveries from a Host Blue or its participating healthcare providers can arise in several ways, including, but not limited to, anti-fraud and abuse recoveries, healthcare provider/hospital audits, credit balance audits, utilization review refunds, and unsolicited refunds. In some cases, the Host Blue will engage a third party to assist in identification or collection of recovery amounts. The fees of such a third party may be netted against the recovery. Recovery amounts determined in this way will be applied in accordance with applicable Inter-Plan Programs policies, which generally require correction on a claim-by-claim or prospective basis.

Return of Overpayments. Under the BlueCard ProgramBlueCard, recoveries from a Host Blue or its from participating healthcare providers of a Host Blue can arise in several ways, including, but not limited to, anti-fraud and abuse recoveriesaudits, healthcare provider/hospital audits, credit balance audits, utilization review refunds, and unsolicited refunds. In some cases, the Host Blue will engage a third party parties to assist in identification discovery or collection of recovery amounts. The fees of such a third party may be are netted against the recovery. Recovery amounts determined in this way amounts, net of fees, if any, will be applied in accordance with applicable Inter-Plan Programs policiesBlueCard Policies, which generally require correction on a claim-by-claim or prospective basis.

Return of Overpayments. Under the BlueCard ProgramBlueCard, recoveries from a Host Blue or its from participating healthcare providers of a Host Blue can arise in several ways, including, including but not limited to, to anti-fraud and abuse recoveriesaudits, healthcare provider/hospital audits, credit balance audits, utilization review refunds, and unsolicited refunds. In some cases, the Host Blue will engage a third party parties to assist in identification discovery or collection of recovery amounts. The fees of such a third party may be are netted against the recovery. Recovery amounts determined in this way amounts, net of fees, if any, will be applied in accordance with applicable Inter-Plan Programs policiesBlueCard Policies, which generally require correction on a claim-by-claim or prospective basis.

Return of Overpayments. Under the BlueCard ProgramBlueCard, recoveries from a Host Blue or its from participating healthcare providers of a Host Blue can arise in several ways, including, but not limited to, anti-fraud and abuse recoveriesaudits, healthcare provider/hospital audits, credit balance audits, utilization review refunds, and unsolicited refunds. In some cases, the Host Blue will engage a third party parties to assist in identification discovery or collection of recovery amounts. The fees of such a third party may be parties are netted against the recovery. Recovery amounts determined in this way amounts, net of fees, if any, will be applied in accordance with applicable Inter-Plan Programs policiesBlueCard Policies, which generally require correction on a claim-by-claim or prospective basis.

Return of Overpayments. Under the BlueCard Program, recoveries from a Host Blue or its participating healthcare providers Participating/In-Network Providers can arise in several ways, including, but not limited to, anti-fraud and abuse recoveries, healthcare provider/hospital audits, credit balance audits, utilization review refunds, and unsolicited refunds. In some cases, the Host Blue will engage a third party to assist in identification or collection of recovery amounts. The fees of such a third party may be netted against the recovery. Recovery amounts determined in this way will be applied in accordance with applicable Inter-Plan Programs policies, which generally require correction on a claim-by-claim or prospective basis. Negotiated (non-BlueCard Program) National Account Arrangements.

Return of Overpayments. Under the BlueCard ProgramBlueCard, recoveries from a Host Blue or its from participating healthcare providers Providers of a Host Blue can arise in several ways, including, but not limited to, anti-fraud and abuse recoveriesaudits, healthcare providerProvider/hospital audits, credit balance audits, utilization review refunds, and unsolicited refunds. In some cases, the Host Blue will engage a third party parties to assist in identification discovery or collection of recovery amounts. The fees of such a third party may be are netted against the recovery. Recovery amounts determined in this way amounts, net of fees, if any, will be applied in accordance with applicable Inter-Plan Programs policiesBlueCard Policies, which generally require correction on a claim-by-claim or prospective basis.

Return of Overpayments. Under the BlueCard Program, recoveries Recoveries from a Host Blue or its participating healthcare providers Providers can arise in several ways, including, but not limited to, anti-fraud and abuse recoveries, healthcare providerProvider/hospital audits, credit balance audits, utilization review refunds, and unsolicited refunds. In some cases, the Host Blue will engage a third party parties to assist in identification or collection of recovery amounts. The fees of such a third party may be netted against the recovery. Recovery amounts determined in this way will be applied in accordance with applicable Inter-Plan Programs policies, which generally require correction on a claim-by-claim or prospective basis.