Common use of Claims Processing Requirements Clause in Contracts

Claims Processing Requirements. 1. The Contractor must maintain an automated claims processing system that registers the date a claim is received by the Contractor, the detail of each claim transaction (or action) at the time the transaction occurs and has the capability to report each claim transaction by date and type to include interest payments. 2. The Contractor claims system must maintain information at the claim and line detail level. The claims system must maintain adequate audit trails and report accurate claims performance measures to MDHHS. 3. The Contractor’s claims system must maintain online and archived files and keep online automated claims payment history for the most current 36 months. 4. The Contractor must retain financial information and records, including all original claim forms, for the time period in accordance with all federal and State laws. 5. All claims data must be easily sorted and produced in formats as requested by MDHHS.

Claims Processing Requirements. 1. The Contractor must maintain an automated claims processing system that registers the date a claim is received by the Contractor, the detail of each claim transaction (or action) at the time the transaction occurs occurs, and has the capability to report each claim transaction by date and type to include interest payments. 2. The Contractor claims system must maintain information at the claim and line detail level. The claims system must maintain adequate audit trails and report accurate claims performance measures to MDHHS. 3. The Contractor’s claims system must maintain online and archived files files, and keep online automated claims payment history for the most current 36 months. 4. The Contractor must retain financial information and records, including all original claim forms, for the time period in accordance with all federal and State laws. 5. All claims data must be easily sorted and produced in formats as requested by MDHHS.