Denial of payment definition

Denial of payment means that the department has denied payment for a medical assistance claim or reduced the level of service payment for a service provided to an individual who was an eligible medical assistance recipient at the time the service was provided or the recoupment or adjustment of a claim, or part of a claim, following an audit or review.
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Denial of payment means that the department has denied payment for a medical assistance claim or reduced the level of service payment for a service provided to an individual who was an eligible medical assistance recipient at the time the service was provided.
Sample 1Sample 2Sample 3

Examples of Denial of payment in a sentence

  • If a facility does not meet the criteria for continuation of payment under subrule 81.37(1), the facility’s provider agreement shall be terminated.81.37(3) Denial of payment.

  • Denial of payment will be equal to the value of the obligations or Services not performed.

  • Temporary management ends when the facility meets any of the conditions specified in § 488.454(c).§ 488.417 Denial of payment for all new admissions.(a) Optional denial of payment.

  • Total Denial of payment Due to non-availability of alternate product.

  • If an acceptable ePoC is not received within 10 calendar days from the receipt of this letter, we will recommend to the CMS Region V Office that one or more of the following remedies be imposed: • Denial of payment for new Medicare and Medicaid admissions (42 CFR 488.417); • Civil money penalty (42 CFR 488.430 through 488.444).

  • Denial of payment is an extreme measure that should never be done for small or insignificant problems.

  • Denial of payment by an insurance carrier or other third party does not waive my responsibility to pay.

  • Denial of payment to an entire bill should occur when the circumstances warrant it.

  • Denial of payment No program administrator may deny to any pharmacy payment for services which may have resulted from the fraudulent or illegal use of an identification card by any person, unless the pharmacy has been notified that the card has been canceled or discontinued and that the program administrator has been unsuccessful in attempting to regain possession of the card.

  • Potential risks associated with failure to register with clinicaltrials.gov: Loss of funding (National Institute of Health) Financial penalty levied against the PI Denial of publication (ICMJE) Denial of payment to healthcare providers.

Related to Denial of payment

  • Copayment means that you pay a fixed amount each time you fill a prescription.

  • Section 409A means Section 409A of the Code and the regulations and other guidance promulgated thereunder.

  • Denial means the process of refusing to grant a license after OCCL receives an application. This constitutes refusal of permission to operate.

  • Qualifying exigency means a situation where the eligible employee seeks leave for one or more of the following reasons:

  • Public health emergency means an emergency with respect to COVID–19 declared by a Federal, State, or local authority.

  • Specific learning disability (SLD) means a heterogeneous group of conditions wherein there is a deficit in processing language, spoken or written, that may manifest itself as a difficulty to comprehend, speak, read, write, spell, or to do mathematical calculations and includes such conditions as perceptual disabilities, dyslexia, dysgraphia, dyscalculia, dyspraxia and developmental aphasia.

  • Qualified employer means the federal government.

  • Cash assistance means cash benefits provided under the family independence program, the refugee assistance program, or state disability assistance.

  • Qualified employee means an individual who: