UNDERPAYMENT/PAYMENTS POST APPEALS Sample Clauses

UNDERPAYMENT/PAYMENTS POST APPEALS a. If the LME/PIHP determines that CONTRACTOR has not been paid a claim or a portion of a claim that the LME/PIHP determines should be allowed for any reason, the LME/PIHP shall provide thirty (30) days notice to the CONTRACTOR of the intent to pay the claims or portions of claims. Such notice of action shall identify the Enrollee(s) name and date(s) of service in question, the specific determination made by the LME/PIHP as to each claim, and the amount of payment due to the CONTRACTOR. CONTRACTOR shall have thirty (30) days from date of such notification to appeal the determination of the LME/PIHP. The LME/PIHP shall make such payment within thirty (30) days of the date of the notice of intent to pay claims or portions of claims.
Sample 1Sample 2Sample 3See All (6)
AutoNDA by SimpleDocs
UNDERPAYMENT/PAYMENTS POST APPEALS. 4.10.1. If Sandhills Center determines that Provider has not been paid a claim or a portion of a claim that Sandhills Center determines should be allowed for any reason, Sandhills Center shall provide thirty (30) days’ notice to the Provider of the intent to pay the claims or portions of claims. Such notice of action shall identify the Member(s) name and date(s) of service in question, the specific determination made by Sandhills Center as to each claim, and the amount of payment due to the Provider. Provider shall have thirty (30) days from date of such notification to appeal the determination of Sandhills Center. Sandhills Center shall make such payment within thirty (30) days of the date of the notice of intent to pay claims or portions of claims.
Sample 1
UNDERPAYMENT/PAYMENTS POST APPEALS. If the LME/PIHP determines that CONTRACTOR has not been paid a claim or a portion of a claim that the LME/PIHP determines should be allowed for any reason, the LME/PIHP shall provide thirty (30) days notice to the CONTRACTOR of the intent to pay the claims or portions of claims. Such notice of action shall identify the Enrollee(s) name and date(s) of service in question, the specific determination made by the LME/PIHP as to each claim, and the amount of payment due to the CONTRACTOR. CONTRACTOR shall have thirty (30) days from date of such notification to appeal the determination of the LME/PIHP. The LME/PIHP shall make such payment within thirty (30) days of the date of the notice of intent to pay claims or portions of claims. Within thirty (30) days of the conclusion of any grievance, appeal or litigation that determines that LME/PIHP improperly failed to pay a claim or a portion of a claim to CONTRACTOR, the LME/PIHP shall remit the amount determined to be owed to CONTRACTOR. REQUIRED APPENDICES/ATTACHMENTS: _____Appendix A Certification Regarding Environmental Tobacco Smoke _____Appendix B Certification Regarding Lobbying _____Appendix C Certification Regarding Drug-Free Workplace _____Appendix D Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transactions _____Appendix E Outcomes and Reporting Requirements _____Appendix F Mixed Services Payment Protocol _____Appendix G Provider Specialty Practice Information _____Attachment A Contracted Services and Qualified/Approved Sites _____Attachment B Provider Disclosure Form REMAINDER OF PAGE BLANK Signature Page Between: <<LOCAL MANAGEMENT ENTITY/PRE-PAID INPATIENT HEALTH PLAN NAME>> and <<PROVIDER NAME>>
Sample 1
UNDERPAYMENT/PAYMENTS POST APPEALS a. If the LME/PIHP determines that Contractor has not been paid a claim or a portion of a claim that the LME/PIHP determines should be allowed for any reason, the LME/PIHP shall provide thirty (30) day notice to the Contractor of the intent to pay the claims or portions of claims. Such notice of action shall identify the Enrollee(s) name and date(s) of service in question, the specific determination made by the LME/PIHP as to each claim, and the amount of payment due to the Contractor. Contractor shall have thirty
Sample 1
UNDERPAYMENT/PAYMENTS POST APPEALS. A. If the BH I/DD Tailored Plan determines that Contractor has not been paid a claim or a portion of a claim that the BH I/DD Tailored Plan determines should be allowed for any reason, the BH I/DD Tailored Plan shall provide notice to the Contractor of the intent to pay the claims or portions of claims. Such notice of action shall identify the Member name and dates of service in question, the specific determination made by the BH I/DD Tailored Plan as to each claim, and the amount of payment due to the Contractor. Contractor shall have thirty (30) days from date of such notification to appeal the determination of the BH I/DD Tailored Plan. The BH I/DD Tailored Plan shall make such payment upon notice of intent to pay claims or portions of claims.
Sample 1

Related to UNDERPAYMENT/PAYMENTS POST APPEALS

  • Underpayment In the event of a change which results in an underpayment to an employee, the employee shall be properly compensated on or before the next possible paycheck following discovery of the error. Upon request, the District shall provide the employee with specific written explanation for the underpayment through the Payroll Contact Person at the employee’s location.

  • Underpayments a. In the event the employee does not receive the wages or benefits to which the record/documentation has for all times indicated the employer agreed the employee was entitled, the Agency shall notify the employee in writing of the underpayment. This notification will include information showing that an underpayment exists and the amount of wages and/or benefits to be repaid. The Agency shall correct any such underpayment made within a maximum period of two (2) years before the notification.

  • Payment of Overpayment If at any time the Province provides Funds in excess of the amount to which the Recipient is entitled under the Agreement, the Province may:

  • Overpayment Provider shall be liable to the GLO for any costs disallowed pursuant to financial and/or compliance audit(s) of funds received under this Contract. Provider shall reimburse such disallowed costs from funds other than those that Provider received under this Contract. Provider must refund disallowed costs and overpayments of funds received under this Contract to the GLO within 30 days after the GLO issues notice of overpayment to Provider.

  • Overpayment of Wages (a) Where the employee has been overpaid all or part of their pay on any occasion they, or the employer, should raise the error immediately.

  • Overpayments Contractor promptly shall refund to Purchaser the full amount of any erroneous payment or overpayment. Such refunds shall occur within thirty (30) calendar days of written notice to Contractor; Provided, however, that Purchaser shall have the right to elect to have either direct payments or written credit memos issued. If Contractor fails to make timely refunds of overpayment(s) (either directly or by credit memo), Contractor shall pay Purchaser interest at the rate of one percent (1%) per month on the amount overdue thirty (30) calendar days after notice to Contractor.

  • Late Payment Surcharge In the event of delay in payment of a Monthly Xxxx by Buyer beyond thirty (30) days of its Due Date, a Late Payment Surcharge shall be payable to the SPD at the rate of 1.25% per month on the outstanding amount calculated on a day to day basis subject to such late payment being duly received by Buyer under the PSA from the Buying Entity(ies). The Late Payment Surcharge shall be claimed by the SPD through the Supplementary Xxxx.

  • OVERPAYMENT OF PURCHASES OR UNDERPAYMENT OF FEES Without limiting any other remedy available to any Purchaser, Contractor shall (a) reimburse Purchasers for any overpayments inconsistent with the terms of this Master Contract or Purchase Orders placed thereunder, at a rate of 125% of any such overpayments, found as a result of the examination of Contractor’s records; and (b) reimburse Enterprise Services for any underpayment of vendor management fees, at a rate of 125% of such fees found as a result of the examination of Contractor’s records (e.g., if Contractor underpays the Vendor Management Fee by $500, Contractor would be required to pay to Enterprise Services $500 x 1.25 = $625); Provided, however, that, in the event Contractor timely discovers and corrects any Purchaser overpayment or Contractor underpayment of vendor management fees and does so prior to the initiation of any audit, Contractor shall be entitled to reimburse Purchaser or pay to Enterprise Services the actual amount of such Purchaser overpayment or such underpayment of vendor management fees.

  • Salary Overpayment Recovery A. When the Employer has determined that an employee has been overpaid wages, the Employer will provide written notice, via certified mail, to the employee that will include the following items:

  • Repayment of Overpayments 17.1 Any salary overpayments will be repaid to the employer within a reasonable period of time.

Time is Money Join Law Insider Premium to draft better contracts faster.