Clean Claims Sample Clauses

Clean Claims. Providers shall prepare and submit Clean Claims to Health Plan within 180 days or such other time period required by Laws or Program Requirements, of the date of a Covered Service or the date of discharge from an inpatient facility, as the case may be. Unless prohibited by Laws and Program Requirements, Health Plan may deny payment for any claims that fail to meet Health Plan’s submission requirements for Clean Claims or that are received after the time limit in this Agreement for filing Clean Claims.
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Clean Claims. For Claims from I/T/Us, day activity Providers, assisted living Providers, NFs and home care agencies, including Community Benefit Providers, United will adjudicate ninety-five percent (95%) of Clean Claims within a time period of no greater than fifteen (15) Calendar Days of receipt and ninety-nine percent (99%) or more of Clean Claims within a time period of no greater than thirty (30) Calendar Days of receipt.
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Clean Claims. “Clean Claims” means claims that conform to the Clean Claim requirements per the Michigan Insurance Code MCL 500.2006 or set forth in MCL 400.111i, or for equivalent claims under Original Medicare, as applicable.
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Clean Claims. (1) A clean claim is a claim submitted by a Provider for payment that has no defect. We shall pay or deny each clean claim as follows. (a) If the claim is filed electronically, within 30 days after the date we receive the claim. (b) If the claim is filed on paper, within 45 days after the date we receive the claim. (2) If we fail to pay or deny a clean claim in the time frames set forth above and subsequently pay the claim, we will pay the Provider that submitted the claim allowable interest in accordance with Indiana Code § 27-8-5.7-6.
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Clean Claims. Providers shall electronically prepare and submit Clean Claims to Health Plan within one year or such other time period required by Laws or Program Requirements, of the date of a Covered Service or the date of discharge from an inpatient facility , as the case may be. Unless prohibited by Laws and Program Requirements, Health Plan may deny payment for any claims that fail to meet Health Plan’s submission requirements for Cle an Claims or that are recei ved after the time limit in this Agreement for filing Clean Claims.
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Clean Claims. In order to be considered clean claims, the Contractor shall submit claims that are timely, complete, accurate, and ready for processing without obtaining additional information from the Contractor or third party. If Coordination of Benefits is required, evidence that the Contractor billed the primary payor shall be included with the claims.
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Clean Claims. HMC shall process in the normal course and pay Clean Claims within thirty (30) days of receipt. HMC may deny payment for any claims that fail to meet HMC’s submission requirements for such claims or which are received after the time limit, under this Agreement, for submitting Clean Claims.
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Related to Clean Claims

  • Litigation; Claims Any rights (including indemnification) and claims and recoveries under litigation of Seller against third parties attributable to the period on or prior to the Closing except to the extent relating to the Assumed Liabilities;

  • Tax Claims Notwithstanding any other provision of this Agreement, the control of any claim, assertion, event or proceeding in respect of Taxes of the Company (including, but not limited to, any such claim in respect of a breach of the representations and warranties in Section 3.22 hereof or any breach or violation of or failure to fully perform any covenant, agreement, undertaking or obligation in Article VI) shall be governed exclusively by Article VI hereof.

  • Administrative Claims Requirements and Procedures No suit or arbitration shall be brought arising out of this Agreement against City unless a claim has first been presented in writing and filed with City and acted upon by City in accordance with the procedures set forth in Chapter 1.34 of the Chula Vista Municipal Code, as same may be amended, the provisions of which, including such policies and procedures used by City in the implementation of same, are incorporated herein by this reference. Upon request by City, Consultant shall meet and confer in good faith with City for the purpose of resolving any dispute over the terms of this Agreement.

  • Claims and Review Procedures 6.1 For all claims other than Disability benefits:

  • Claims and Review Procedure In the event that any claim for benefits that must initially be submitted in writing to the Board of Directors, is denied (in whole or in part) hereunder, the claimant shall receive from First Charter a notice of denial in writing within 60 days, written in a manner calculated to be understood by the claimant, setting forth the specific reasons for denial, with specific reference to pertinent provisions of this Supplemental Agreement. Any disagreements about such interpretations and construction shall be submitted to an arbitrator subject to the rules and procedures established by the American Arbitration Association. The arbitrator shall be acceptable to both First Charter and the Executive (or Beneficiary); if the parties cannot agree on a single arbitrator, the disagreement shall be heard by a panel of three arbitrators, with each party to appoint one arbitrator and the third to be chosen by the other two. No member of the Board of Directors shall be liable to any person for any action taken under Article VIII except those actions undertaken with lack of good faith.