Compliance Dispute definition

Compliance Dispute means any claim that Company has failed to carry out any of its obligations under § 7 of this Agreement (with the exception of § 7.29(f)); provided, however, that none of the following shall be deemed a Compliance Dispute: (A) a Released Claim, (B) a Retained Claim, (C) a Billing Dispute; (D) a claim for which the Adverse Determination Review Process is available.
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Compliance Dispute shall have the meaning set forth in Section 5.11(a).
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Compliance Dispute means (i) any claim that Company has failed in any manner to carry out any of its obligations under § 7 of this Agreement and (ii) any claim of the type described in §13(e)(2) of this Agreement that is not also any of the following: (A) a Released Claim, (B) a Retained Claim, (C) a Billing Dispute;(D) a claim for which the Medical Necessity External Review Process is available, or (E) a claim challenging a Medical Necessity determination arising out of administration of benefits for a Self-Funded Plan as to which the Plan Sponsor has not elected to participate in Company’s Medical Necessity External Review Process.
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Examples of Compliance Dispute in a sentence

  • First Federal Savings and Loan Ass’n of Berwyn, 312 N.E.2d 605, 610-11 (Ill.

  • For insured incident Legal defence Statutory notice appeals, the date when the Insured Person is issued with the relevant notice and has the right to appeal.Employer Compliance Dispute A dispute with HM Revenue & Customs concerning Your compliance with Pay As You Earn, Social Security, Construction Industry or IR35 legislation and regulations.Identity Theft The theft or unauthorised use of Your personal identification which has resulted in the unlawful use ofYour identity.

  • Employer Compliance Dispute A dispute with HM Revenue & Customs concerning the Insured’s compliance with Pay As You Earn, Social Security, Construction Industry or IR35 legislation and regulations.

  • Petitioner shall have no right to appeal the Compliance Dispute Facilitator’s decision.

  • Unless the Petitioner specifies otherwise, the Compliance Dispute Facilitator shall serve as the Petitioner’s representative in the Compliance Dispute process thereafter with respect to such Compliance Dispute.

  • Employer Compliance Dispute A dispute with HM Revenue & Customs concerning Your compliance with Pay As You Earn, Social Security, Construction Industry or IR35, legislation and regulations.

  • The Compliance Dispute Review Officer may deny the petition for rehearing or issue a new written opinion after considering such a petition.

  • Petitioner or Company may, at the time of submission of the memoranda described in § 12.6(b), request oral argument before the Compliance Dispute Review Officer on the subject of the Compliance Dispute and appropriate remedies, if any.

  • The costs of acquiring the land in regard to valuation and conveyance will be in the vicinity of $1,200 per parcel.

  • In the event of a Settlement Agreement Compliance Dispute, the Licensee shall, upon notice, call together the interested Parties to engage in Consultation pursuant to Section 6.2 to (i) determine whether noncompliance has occurred, and, (ii) in the event of noncompliance, establish a time in which the offending Party must cure the noncompliance.


More Definitions of Compliance Dispute

Compliance Dispute includes (a) any threatened, pending or completed action, suit, proceeding, 135 penalty, or alternative dispute resolution mechanism, whether civil, criminal, administrative, arbitrative, investigative or other, and whether made pursuant to federal, state or other law; or (b) any inquiry, hearing or investigation that Xxxxxxxxxx determines might lead to the institution of any such action, suit, proceeding, penalty, or alternative dispute resolution mechanism.
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Compliance Dispute means (i) any claim that CIGNA HealthCare has failed to carry out any of its obligations under Section 7 of this Agreement (with the exception of Section 7.29.f); provided, however, that none of the following shall be deemed a Compliance Dispute:
Sample 1
Compliance Dispute means any claim that Company has failed to carry out any of its obligations under this agreement; provided, however, that none of the following shall be deemed a Compliance Dispute: (a) a Released Claim, (b) a Retained Claim, (c) a Billing Dispute as defined in the Shane Settlement Agreement; and (d) a claim for which the Adverse Determination review process set forth in Section 7.11 of the Shane Settlement Agreement is available.
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Compliance Dispute means any claim that Company has failed to carry out any of its obligations under § 7 of this Agreement (with the exception of § 7.29(f)); provided, however, that none of the following shall be deemed a Compliance Dispute: (a) a Released Claim; (b) a Retained Claim; (c) a Billing Dispute; and (d) a claim for which the Adverse Determination Review Process is available.
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Compliance Dispute means any claim that Company has failed to carry out any of its obligations under § 7 of this Agreement (with the exception of
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Related to Compliance Dispute

  • Technical Dispute has the meaning specified in Section 12.2;

  • trade dispute means any dispute or difference between employers and workmen, or between workmen and workmen, connected with the employment or non-employment, or the terms of employment, or with the conditions of labour, of any person;

  • Billing Dispute means the dispute of an invoice prepared by an Operator to the Other Operator which is made in good faith.

  • Labor dispute as used here, means a strike, lockout, or other labor dispute between the Employer and its Employees, during which time the Employee is not paid by the Employer.

  • Reconciliation Dispute has the meaning set forth in Section 7.9 of this Agreement.

  • Arbitrable Dispute means any dispute arising under or in connection with this Agreement.

  • Dispute Resolution Process means the process described in clause 9

  • Dispute Resolution Procedures means the procedures outlined in Annexure A of the MSA Determination.

  • Complaints Procedure means the School's procedure for handling complaints from parents, as amended from time to time for legal or other substantive reasons, or in order to assist the proper administration of the School. It does not form part of the contract between you and the School. A copy of the most up-to-date procedure is on the School's website and is otherwise available from the School at any time upon request;

  • Alternative dispute resolution means mediation, arbitration, conciliation, or other nonjudicial procedure that involves a neutral party in the decisionmaking process. The form of alternative dispute resolution chosen pursuant to this article may be binding or nonbinding, with the voluntary consent of the parties.

  • Dispute means any dispute, controversy, claim or difference of whatever nature arising out of, relating to, or having any connection with this Agreement, including a dispute regarding the existence, formation, validity, interpretation, performance or termination of this Agreement or the consequences of its nullity and also including any dispute relating to any non-contractual rights or obligations arising out of, relating to, or having any connection with this Agreement.

  • Agreement Disputes shall have the meaning set forth in Section 6.1.

  • Formal Dispute means a written objection by an Interested Party to any of the following:

  • Dispute Resolution Procedure means the procedure for resolution of Disputes set forth in Article 26;

  • Xxxx Dispute Notice means the notice issued by a Party raising a Dispute regarding a Monthly Xxxx or a Supplementary Xxxx issued by the other Party;

  • Legal Dispute means any action, suit or proceeding between or among the Parties arising in connection with any disagreement, dispute, controversy or claim arising out of or relating to this Agreement or any related document.

  • Expedited Dispute Timetable means the timetable set out in paragraph 164 of Call Off Schedule 11 (Dispute Resolution Procedure);

  • StarCompliance Code of Ethics application means the web-based application used to electronically pre-clear personal securities transactions and file many of the reports required herein. The application can be accessed via the AB network at: https://alliance-ng.starcompliance.com/.

  • Participating Certified Clinical Nurse Specialist means a Certified Clinical Nurse Specialist who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • dispute resolution proceeding ’ means any process in which an alternative means of dispute resolution is used to resolve an issue in controversy in which a neutral is appointed and specified parties participate;

  • Relevant Dispute means any difference between the parties arising out of or in connection with this contract; "Relevant Force Majeure Event" has the meaning ascribed to it in Clause 17.1;

  • consumer dispute means a dispute where the person against whom a complaint has been made, denies or disputes the allegations contained in the complaint;

  • Mediation means any process in which a mediator facilitates communication and negotiation between the parties to assist them in reaching a voluntary agreement regarding their dispute.

  • Non-Participating Certified Clinical Nurse Specialist means a Certified Clinical Nurse Specialist who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Compliance Forester means the DNR staff person(s) identified in the Pre-Work Conference who perform the compliance inspections, approve Work, recommend payment to the Contract Manager, and manage the Work Schedule.

  • Disputing Party has the meaning specified in Paragraph 5.