Compensation and Billing 6.1 The Provider shall seek payment only from DRS for the provision of Infusion Therapy services except as provided in paragraph 6.3. The payment from DRS shall be limited to the amounts referred to in paragraph 6.2.
6.2 DRS agrees to pay the Provider’s billed charge for each procedure or the fee set by DRS for that procedure, whichever is less. DRS shall have the right to categorize what shall constitute a procedure. DRS and the beneficiary’s financial liability shall be limited to the procedure’s allowable as determined by DRS, paid by applying appropriate coding methodology, whether the Provider has billed appropriately or not.
6.3 The Provider agrees to accept the payment from DRS as full and complete payment for services for recipients of public assistance. If the patient is a recipient of Medical Assistance, Rehabilitation Services only, payment from the Department shall represent payment in full except the Provider may collect an amount not to exceed that shown on DRS form, DRS-C-100, Medical Services Authorization.
6.4 The Provider shall refund within 30 days of discovery to DRS any overpayments made by DRS.
6.5 The Provider shall bill DRS on forms acceptable to DRS within 1 year of providing the medical services. The Provider shall use the current HCPCS codes, CPT codes and ICD codes, when applicable. The Provider shall furnish, upon request at no cost, all information, including medical records, reasonable required by DRS to verify and substantiate the provision of medical services and the charges for such services if the beneficiary and the Provider are seeking reimbursement through DRS.
6.6 DRS shall reimburse the Provider within 30 days of receipt of xxxxxxxx that are accurate, complete and otherwise in accordance with Article VI of this Contract. DRS will not be responsible for delay of reimbursement due to circumstances beyond DRS’ control.
6.7 The Provider agrees to release all Provider liens for which payment has been made for Title XIX by DRS and notify DRS. However, this provision does not affect the Provider’s entitlement to file a lien or liens for non-pre-authorized services.
6.8 DRS shall have the right at all reasonable times and to the extent permitted by law to inspect and duplicate all medical and billing records relating to medical services rendered to beneficiaries at no cost to DRS or the beneficiary.
Developer Compensation for Emergency Services If, during an Emergency State, the Developer provides services at the request or direction of the NYISO or Connecting Transmission Owner, the Developer will be compensated for such services in accordance with the NYISO Services Tariff.
Interconnection Customer Compensation If the CAISO requests or directs the Interconnection Customer to provide a service pursuant to Articles 9.6.3 (Payment for Reactive Power) or 13.5.1 of this LGIA, the CAISO shall compensate the Interconnection Customer in accordance with the CAISO Tariff.
Processing of a Grievance It is recognized and accepted by the Union and the Employer that the processing of grievances as hereinafter provided is limited by the job duties and responsibilities of the employees and shall therefore be accomplished during normal working hours only when consistent with such employee duties and responsibilities. The aggrieved employee and a Union representative shall be allowed a reasonable amount of time without loss of pay when a grievance is investigated and presented to the Employer during normal working hours provided that the employee and the Union representative have notified and received the approval of the designated supervisor who has determined that such absence is reasonable and would not be detrimental to the work programs of the Employer.
Intercarrier Compensation Except as specifically described in this Section, the Agreement does not change or amend applicable intercarrier compensation arrangements (including but not limited to Switched Access, Signaling, or Transit charges) between any parties, including between Qwest and Carriers or IXCs.
