Beginning August. 1, 2000, the contractor shall provide a participating, PIP-qualifying hospital with an initial 60-day PIP (representing two 30-day cash advances) which shall be reconciled using a claims offset process, with the first 30-day PIP reconciled to claims adjudicated during the first month following the initial PIP (August), and the second 30-day PIP reconciled to claims adjudicated during the second month following the initial PIP (September). In September 2000 and all subsequent months, the hospital shall receive a 30-day PIP which shall be offset against claims adjudicated at the end of the following month. At reconciliation, any excess claims adjudicated above the PIP amount shall result in an additional payment to the hospital equal to the value of any excess claims above the PIP. If the value of claims adjudicated is less than the PIP, the shortage shall be offset against the next PIP made to the hospital. An example of how this methodology shall work is as follows:
Appears in 2 contracts
Sources: Contract to Provide Services (Amerigroup Corp), Contract to Provide Services (Centene Corp)