Common use of SERVICE REPORTING AND CLAIMS OVERPAYMENT POLICY Clause in Contracts

SERVICE REPORTING AND CLAIMS OVERPAYMENT POLICY. I. Service Reporting Provider will furnish a claim or a report to BCBSM in the form BCBSM specifies and furnish any additional information BCBSM may reasonably request to process or review the claim. All services shall be reported without charge, with complete and accurate information, including diagnosis, and procedure or revenue codes approved by BCBSM, license number or other required identifier of prescribing physician/provider, and such other information as may be required or published by BCBSM to adjudicate claims. Provider agrees to use reasonable efforts to cooperate with and assist BCBSM in coordinating benefits with other sources of coverage for Covered Services by requesting information from Members, including but not limited to information pertaining to workers’ compensation, other group health insurance, third party liability and other coverages. Provider further agrees to identify those Members with Medicare coverage and to xxxx BCBSM or Medicare consistent with applicable federal and state laws and regulations. When Provider is aware the patient has primary coverage with another third party payer or entity, Provider agrees to submit the claim to that party before submitting a claim for the services to BCBSM.