Common use of Return of Overpayments Clause in Contracts

Return of Overpayments. Recoveries from a Host Blue or its participating and nonparticipating providers can arise in several ways, including, but not limited to, anti-fraud and abuse recoveries, provider/hospital bill audits, credit balance audits, utilization review refunds and unsolicited refunds. Recoveries will be applied so that corrections will be made, in general, on a claim-by-claim or prospective basis. If recovery amounts are passed on a claim-by- claim basis from a Host Blue to us, they will be credited to your account. 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 charged to you as a percentage of the recovery.

Return of Overpayments. Recoveries of overpayments/from a Host Blue or its participating and nonparticipating non-participating providers can arise in several ways, including, but not limited to, anti-fraud and abuse recoveries, audits/health care provider/hospital bill audits, credit balance audits, utilization review refunds and unsolicited refunds. Recoveries will be applied so that corrections will be made, in general, on either a claim-by-claim or prospective basis. If recovery amounts are passed on a claim-by- by-claim basis from a Host Blue to usthe Plan, they will be credited to your account. In some comes cases, the Host Blue will engage a third party to assist in identification or collection of recovery amountsoverpayments. The fees of such a third party may be charged to you as a percentage of the recovery.

Return of Overpayments. Recoveries from a Host Blue or its participating and nonparticipating providers can arise in several ways, including, but not limited to, anti-fraud and abuse recoveries, healthcare provider/hospital bill xxxx audits, credit balance audits, utilization review refunds and unsolicited refunds. Recoveries Recovery amounts determined in the ways noted above will be applied so that corrections will be madeapplied, in general, on either a claim-by-claim or prospective basis. If recovery amounts are passed on a claim-by- claim basis from a Host Blue to usHMSA, they will be credited to your Client’s account. 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 charged to you HMSA as a percentage of the recovery.

Return of Overpayments. Recoveries from a Host Blue or its participating and nonparticipating providers can arise in several ways, including, but not limited to, anti-fraud and abuse recoveries, audits/healthcare provider/hospital bill audits, credit balance audits, utilization review refunds and unsolicited refunds. Recoveries will be applied so that corrections will be made, in general, on either a claim-by-claim or prospective basis. If recovery amounts are passed on a claim-by- by-claim basis from a Host Blue to us, they will be credited to your account. 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 charged to you as a percentage of the recovery.