Common use of Third Party Billing Clause in Contracts

Third Party Billing. a. The Managing Entity and the Department are intended to be Payors of last resort. The Network Service Provider shall adhere to the following guidelines for payment and billing: (1) The Network Service Provider shall not bill the Managing Entity for services provided to: (a) Individuals who have third party insurance coverage when the services provided are paid under the insurance plan; or (b) Recipients of Medicaid, or another publicly funded health benefits assistance program, when the services provided are paid by said program. (2) The Network Service Provider shall comply with the terms and conditions of 65E- 14, F.A.C. in determining which individuals to bill to the Managing Entity. b. The Network Service Provider shall report Medicaid earnings and earnings from other publicly funded health benefits assistance programs separately from all other fees.

Third Party Billing. a. The Managing Entity and the Department are intended to be Payors of last resort. The Network Service Provider shall adhere to the following guidelines for payment and billing: (1) The Network Service Provider shall not bill xxxx the Managing Entity for services provided to: (a) Individuals who have third party insurance coverage when the services provided are paid under the insurance plan; or (b) Recipients of Medicaid, or another publicly funded health benefits assistance program, when the services provided are paid by said program. (2) The Network Service Provider shall comply with the terms and conditions of 65E- 14, F.A.C. in determining which individuals to bill xxxx to the Managing Entity. b. The Network Service Provider shall report Medicaid earnings and earnings from other publicly funded health benefits assistance programs separately from all other fees.

Third Party Billing. a. The Managing Entity and the Department are intended to be Payors of last resort. The Network Service Provider shall adhere to the following guidelines for payment and billing: (1) The Network Service Provider shall not bill xxxx the Managing Entity for services provided to: (a) Individuals who have third party insurance coverage when the services provided are paid under the insurance plan; or (b) Recipients of Medicaid, or another publicly publically funded health benefits assistance program, when the services provided are paid by said program. (2) The Network Service Provider shall comply with the terms and conditions of 65E- 1465E-14, F.A.C. in determining which individuals to bill xxxx to the Managing Entity. b. The Network Service Provider shall report Medicaid earnings and earnings from other publicly publically funded health benefits assistance programs separately from all other fees.