USDVA, Medicare, Medi-Cal, Private Insurance and Various Billing Information Sample Clauses

USDVA, Medicare, Medi-Cal, Private Insurance and Various Billing Information. The Contractor shall verify the CalVet Resident’s USDVA, private insurance, Medicare, and/or Medi-Cal eligibility. If applicable Contractor, shall be responsible for obtaining required Medicare and Medi-Cal authorization. Contractor or Contractor’s contract/referral providers shall use their own National Provider Identification Number to xxxx USDVA, private insurance, Medicare, and Medi-Cal prior to billing CalVet. Contractor shall xxxx XxxXxx for the resident’s USDVA, private insurance, Medicare, or Medi-Cal health care services deductible, co-payment, or share-of-cost. Contractor shall collect and assemble Contractor’s contract/referral provider invoices and forward to CalVet. Each invoice must provide the information specified in this Agreement. Contractor shall accept and treat residents who do not have medical insurance or have exhausted their Medicare/Medi-Cal benefits in accordance with Exhibit B-1, Agreement Rates. CalVet shall make every effort to inform the Contractor when a resident is eligible for treatment of a service-connected illness. Contractor shall request treatment authorization from USDVA within seventy- two (72) hours of resident’s admission. If treatment authorization is granted by USDVA, Contractor shall xxxx USDVA prior to billing Medicare, Medi-Cal, or CalVet. Contractor shall submit bills on the appropriate claim form adopted by Health Care Financing Administration for Contractor billing. Medicare, Medi-Cal or insurance denials due to improper claim information shall be the responsibility of the Contractor. Invoices shall never be submitted to the resident(s) of the Home under any circumstances when a referral has been received from the Home. Contractor shall not, under any circumstances, including the Home’s non-payment, insolvency, breach or termination of this contract, seek compensation from, have any recourse against, or impose any additional charges on any resident(s). Contractor shall look only to the State for payment. If the State receives notice the Contractor has billed or collected monies from a Home resident(s), the Contractor shall refund that amount to the Veterans Home resident(s). Contractor or Contractor’s Providers, Agents, Trustees, or Assignees, shall not maintain any action at law against a Home resident to collect funds owed by the Home.
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Related to USDVA, Medicare, Medi-Cal, Private Insurance and Various Billing Information

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