Retroactive denial definition

Retroactive denial means the practice of denying previously paid claims by
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Retroactive denial means the practice of denying previously paid claims by withholding or setting off against payments, or in any other manner reducing or affecting the future claim payments to the provider, or to seek direct cash reimbursement from a provider for a payment previously made to the provider.
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Retroactive denial means the practice of denying
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Examples of Retroactive denial in a sentence

  • Retroactive denial of a previously paid claim" or "retroactive denial of payment" means any attempt by a carrier retroactively to collect payments already made to a claimant with respect to a claim, or any portion thereof, by requiring repayment of such payments, by reducing other payments currently owed to the claimant, by withholding or setting off against future payments, or in any other manner reducing or affecting the future claim payments to the claimant.

  • Retroactive denial of a previously paid claim or retroactive denial of payment means any attempt by Delta Dental of Virginia retroactively to collect payments already made to you with respect to a claim by reducing other payments currently owed to you, by withholding or setting off against future payments, or in any other manner reducing or affecting the future claim payments to you.

  • DERWARTDeputy Commissioner Bulletin 22-08 Date: June 28, 2022 To: All Life & Health Insurers; Nonprofit Health Service Plans; Health Maintenance Organizations and Managed Care Organizations Re: Section 15-1008(c)(ii): Retroactive denial of health claims The purpose of this Bulletin is to remind carriers of their obligation to promptly acknowledge responsibility for a covered health service when requested to do so by another carrier seeking to coordinate benefits under Md. Ann.

  • Retroactive denial of the exemption, and collection of sales taxes formerly exempted under the owner builder certificate.

  • Retroactive denial of a previously paid claim" or "retroactive denial of payment" means any attempt by a carrier retroactively to collect payments already made to a claimant with respect to a claim, or any portion thereof, by requiring repayment of such payments, by reducing other payments owed to the claimant, by withholding or setting off against future payments, or in any other manner reducing or affecting the future claim payments to the claimant.

  • Recoupment from future provider payments; * * * (H) Attendance at provider education sessions; * * * (J) One hundred percent (100%) review of the provider's claims prior to payment[.] * * * (M) Retroactive denial of payments; * * * (5) Amounts Due the Department of Social Services From a Provider.

  • Sex education is frequently perceived as interference in Russian traditions coming from abroad, usually from the West, to “destroy Russia” and teach teenagers “not how to create a family and raise children but how to avoid pregnancy and get pleasure from copulation” (Meylakhs, 2011, p.

  • Retroactive denial of a previously paid claim or retroactive denial of payment means any attempt by DDVA retroactively to collect payments already made to you with respect to a claim by reducing other payments currently owed to you, by withholding or setting off against future payments, or in any other manner reducing or affecting the future claim payments to you.

Related to Retroactive denial

  • Retroactive Date means the date specified in the Schedule.

  • Reduced leave schedule means a leave schedule that reduces the usual number of hours per workweek, or hours per workday, of an employee.

  • Benefit year means the period of twelve consecutive months, July 1 through June 30, as established by an employer in which an employee shall accrue and use earned sick leave as provided pursuant to N.J.S.A. 34:11D-2, provided that once the starting date of the benefit year is established by the employer it shall not be changed unless the employer notifies the Commissioner of Labor and Workforce Development of the change in accordance with regulations promulgated pursuant to the Act. The Commissioner shall impose a benefit year on any employer the Commissioner determines is changing the benefit year at times or in ways that prevent the accrual or use of earned sick leave by an employee.

  • Enrollee point-of-service cost-sharing means amounts paid to

  • Retrospective review means a review of medical necessity conducted after services have been provided to a patient, but does not include the review of a claim that is limited to an evaluation of reimbursement levels, veracity of documentation, accuracy of coding, or adjudication for payment.

  • extended reduction period means the period for which a person is in receipt of an extended reduction in accordance with paragraph 89, 96 or 101;

  • Excess Compensation means Compensation in excess of the following Integration Level: (Choose (1) or (2))

  • Net direct written premiums means direct gross premiums written in this state on insurance policies subject to this chapter, less return premiums and dividends paid or credited to policyholders on such direct business. “Net direct written premiums” does not include premiums on a contract between insurers or reinsurers.

  • Base Year means the period set forth in Section 5 of the Summary.

  • extended reduction means a reduction under this scheme for which a person is eligible under Part 12 (extended reductions);

  • Prior Year means the year commencing 1 April immediately prior to the relevant Charging Year;

  • License year means the period of time for which a

  • Limitation Year means the Plan Year.

  • Covered Compensation means any Incentive-Based Compensation granted, vested or paid to a person who served as an Executive Officer at any time during the performance period for the Incentive-Based Compensation and that was Received (i) on or after October 2, 2023 (the effective date of the Nasdaq listing standards), (ii) after the person became an Executive Officer, and (iii) at a time that the Company had a class of securities listed on a national securities exchange or a national securities association such as Nasdaq.

  • Capacity Benefit Margin or “CBM” shall mean the amount of firm transmission transfer capability preserved by the transmission provider for Load-Serving Entities (“LSEs”), whose loads are located on that Transmission Service Provider’s system, to enable access by the LSEs to generation from interconnected systems to meet generation reliability requirements. Preservation of CBM for an LSE allows that entity to reduce its installed generating capacity below that which may otherwise have been necessary without interconnections to meet its generation reliability requirements. The transmission transfer capability preserved as CBM is intended to be used by the LSE only in times of emergency generation deficiencies.