BASIS FOR REIMBURSEMENT Clause Samples
The "Basis for Reimbursement" clause defines the method and criteria by which a party will be repaid for costs or expenses incurred under a contract. Typically, this clause specifies whether reimbursement will be based on actual costs, predetermined rates, or a fixed fee, and may outline the documentation required to support reimbursement claims. Its core practical function is to ensure transparency and fairness in the reimbursement process, reducing disputes by clearly establishing how and when payments will be made.
BASIS FOR REIMBURSEMENT. COUNTY shall pay CONTRACTOR for the actual costs 27 of providing the services described hereunder, less revenues which are actually received by 28 CONTRACTOR; provided, however, that CONTRACTOR’s costs are allowable pursuant to county, 29 state, and federal regulations. Non-compliance will require the completion of CAPs by 30 CONTRACTOR. If CAPs are not completed within timeframes as determined by ADMINISTRATOR, 31 payments may be reduced accordingly. Furthermore, if CONTRACTOR is ineligible to provide 32 services due to non-compliance with licensure and/or certification standards of the State, COUNTY or 33 OCPD, ADMINISTRATOR may elect to reduce COUNTY’s maximum obligation proportionate to the 34 length of time that CONTRACTOR is ineligible to provide services.
BASIS FOR REIMBURSEMENT. PDA shall reimburse allowable expenses incurred by the COUNTY on a Fixed Rate Per Pound (FRPP) basis.
BASIS FOR REIMBURSEMENT. As compensation to CONTRACTOR for services provided pursuant to the Agreement, COUNTY shall pay CONTRACTOR monthly in arrears at $55.00 per bed day served at CONTRACTOR’s facility for all Recovery Residence Services for substance users, provided however, that the total of all such payments to CONTRACTOR and all other COUNTY contract providers for all Recovery Residence Services shall not exceed COUNTY’s Aggregate Maximum Obligation as set forth in the Referenced Contract Provisions of the Agreement; and provided further, that CONTRACTOR’s costs are allowable pursuant to applicable county, federal, and state regulations. Non- compliance will require the completion of CAP by CONTRACTOR. If CAPs are not completed within timeframes as determined by ADMINISTRATOR, payments may be reduced accordingly. All payments are interim payments only, and subject to final settlement in accordance with the Cost Report Paragraph of the Agreement.
BASIS FOR REIMBURSEMENT. As compensation to CONTRACTOR for services provided pursuant to the Contract, COUNTY shall pay CONTRACTOR at the following rates of reimbursement; provided, however, the total of all payments to CONTRACTOR under this Contract shall not exceed COUNTY’s Total Amount Not to Exceed as set forth in the Referenced Contract Provisions of the Contract; and provided further, that CONTRACTOR’s costs are allowable pursuant to applicable COUNTY, federal, and state regulations. Furthermore, if CONTRACTOR is ineligible to provide services due to non- compliance with licensure and/or certification standards of the state or COUNTY, ADMINISTRATOR may elect to reduce COUNTY’s Total Amount Not to Exceed proportionate to the length of time that CONTRACTOR is ineligible to provide services. CONTRACTOR shall ensure compliance with all Medi-Cal billing and documentation requirements when entering Units of Service (UOS) into COUNTY IRIS system. ADMINISTRATOR may reduce, withhold or delay any payment associated with non-compliant billing practices or non-compliant licensure and/or certification. If Corrective Action Plans (CAP) are not completed within timeframes as determined by ADMINISTRATOR, payments may be reduced accordingly.
BASIS FOR REIMBURSEMENT. 1. Professional growth reimbursement is offered as an incentive to certificated/licensed employees to continue formal training; college or university credits will be used to earn professional growth reimbursement.
2. Twenty thousand dollars ($20,000) shall be budgeted each year for this purpose and is to be divided as follows:
a. Ten thousand dollars ($10,000) for fall semester; five thousand dollars ($5,000) for spring semester; and five thousand dollars ($5,000) for summer semester.
b. The amount of reimbursement will be based on a per-credit amount which shall be determined by dividing the semester allocation by the number of credit hours for which reimbursement has been applied for by bargaining unit members for said semester.
c. The bargaining unit member shall submit proof of payment and transcript to the Superintendent by January 15 for the fall semester; by June 15 for the spring semester; and by September15 for the summer semester.
d. Any reimbursement will not exceed the amount the bargaining unit member paid for such courses.
e. Payment will be rendered within thirty (30) days of deadline specified in Section B(2)(c) above.
BASIS FOR REIMBURSEMENT. As compensation to CONTRACTOR for services provided pursuant to the Agreement, COUNTY shall pay CONTRACTOR monthly in arrears at the State Mandated NTP DMC ODS rates of reimbursement, as listed below, or as amended by State mandate: Service Unit of Service Fee Determination Regular DMC Rate per unit Perinatal DMC Rate per unit Physician Consultation 15 minute increments County Determined $89.30 $89.30 NTP – Buprenorphine - Mono Daily State Mandated $30.02 $35.20 NTP – Buprenorphine - Naloxone Combination Daily State Mandated $30.81 $35.98 NTP - Disulfiram Daily State Mandated $10.88 $11.05 NTP – Naloxone: 2-pack Dispensed according to need State Mandated $144.66 $144.66 NTP - Methadone Daily State Mandated $14.65 $15.78 NTP – Individual Counseling 10 minute increments State Mandated $17.18 $24.60 NTP – Individual Group 10 minute increments State Mandated $4.06 $8.22 Service Unit of Service Fee Determination Regular DMC Rate per unit Perinatal DMC Rate per unit NTP – Individual Counseling 10 minute increments State Mandated $17.18 $24.60 NTP – Individual Group 10 minute increments State Mandated $4.06 $8.22 MAT will be reimbursed for onsite administration and dispensing at NTP programs; additionally, physicians and licensed prescribers in DMC programs will be reimbursed for the ordering, prescribing, administering, and monitoring of MAT as per DMC-ODS Waiver STC’s. However, the total of monthly payments to CONTRACTOR shall not exceed COUNTY’s Amount Not To Exceed set forth in the Referenced Contract Provisions of the Agreement and provided further, that CONTRACTOR’s costs are allowable pursuant to applicable COUNTY, federal and state regulations. Non-compliance will require the completion of a CAPby CONTRACTOR. If CAPs are not completed within timeframes approved by ADMINISTRATOR, payments may be reduced accordingly.”MAT will be reimbursed for onsite administration and dispensing at NTP programs; additionally, physicians and licensed prescribers in DMC programs will be reimbursed for the ordering, prescribing, administering, and monitoring of MAT as per DMC-ODS Waiver STC’s. However, the total of monthly payments to CONTRACTOR shall not exceed COUNTY’s Maximum Obligation set forth in the Referenced Contract Provisions of the Agreement and provided further, that CONTRACTOR’s costs are allowable pursuant to applicable COUNTY, federal and state regulations. Non-compliance will require the completion of a CAP by CONTRACTOR. If CAPs are not completed within time...
BASIS FOR REIMBURSEMENT. If the A/E is required to perform travel (other than such travel made at the A/E's own decision or caused by actions for which the A/E is responsible) in excess of travel required under this contract, as approved by the Contracting Officer, he will be reimbursed for transportation and other travel costs. Costs other than transportation (such as lodging, subsistence and related items) will be reimbursable on a per diem basis in lieu of the actual costs incurred.
BASIS FOR REIMBURSEMENT. As compensation to CONTRACTOR for services provided pursuant to the Contract, COUNTY shall pay CONTRACTOR at the following Fee for Service rates of reimbursement; provided, however, the total of all payments to CONTRACTOR under this Contract and all other COUNTY contractors providing substance use disorder treatment services shall not exceed COUNTY’s Aggregate Amount Not to Exceed as set forth in the Referenced Contract Provisions of the Contract; and provided further, that CONTRACTOR’s costs are allowable pursuant to applicable COUNTY, federal, and state regulations. Furthermore, if CONTRACTOR is ineligible to provide services due to non-compliance with licensure and/or certification standards of the State or OCPD, ADMINISTRATOR may elect to reduce COUNTY’s Aggregate Amount Not to Exceed proportionate to the length of time that CONTRACTOR is ineligible to provide services. CONTRACTOR shall ensure compliance with all DMC billing and documentation requirements when entering Units of Service (UOS) into COUNTY IRIS system. ADMINISTRATOR may reduce, withhold or delay any payment associated with non-compliant billing practices or non-compliant licensure and/or certification. If Corrective Action Plans (CAP) are not completed within timeframes as determined by ADMINISTRATOR, payments may be reduced accordingly.
1. For DMC services provided pursuant to the Contract, COUNTY shall claim reimbursement to the State Medi-Cal unit on behalf of CONTRACTOR to the extent these services are eligible.
2. Proper DMC certification and enrollment with the Provider Enrollment Division (PED) of DHCS, through the Provider Application and Validation for Enrollment (PAVE) system is required. CONTRACTOR shall submit proof of enrollment for each new rendering provider as required by regulations. Failure to demonstrate provider enrollment within six (6) months of services being rendered shall result in disallowance of those services by pending providers.
3. CONTRACTOR shall submit appropriate DMC billing invoices to ADMINISTRATOR on a monthly basis. The monthly invoice(s) shall match what CONTRACTOR has entered into IRIS at the time of invoice submission. Supplemental invoice(s) can be submitted if CONTRACTOR has services not yet entered into IRIS at time of original submission. It is CONTRACTOR’s responsibility to ensure the monthly DMC billing invoice UOS that CONTRACTOR provided to ADMINISTRATOR for submission to the State Medi- Cal unit matches the UOS that CONTRACTOR entered into...
BASIS FOR REIMBURSEMENT. The Contract Price to be paid by Owner to Contractor shall include the following:
BASIS FOR REIMBURSEMENT. COUNTY shall pay Contracting Clinics at the following 3 rates per visit; provided, however, that the total of all payments to all Contracting Clinics does not 4 exceed the Aggregate Maximum Obligation as specified in the Referenced Contract Provisions of the 5 Agreement.
6 1. $70.00 per visit for Direct Dental Services
7 2. $84.00 per visit for Direct Medical Services 8 3. $51.00 per visit for Direct Mental Health Services