Common use of Paybacks Clause in Contracts

Paybacks. a. If CARDINAL INNOVATIONS determines CONTRACTOR has failed to comply with State, Federal, Medicaid or any other CARDINAL INNOVATIONS’ revenue source requirements, CARDINAL INNOVATIONS will recoup the amount owed to CARDINAL INNOVATIONS from current and/or future claims. If payback amount exceeds outstanding provider claims, CARDINAL INNOVATIONS will invoice CONTRACTOR the amount owed to CARDINAL INNOVATIONS. CONTRACTOR shall have thirty (30) calendar days from the invoice date to pay back the total amount owed. If CONTRACTOR fails to repay funds identified as requiring payback to CARDINAL INNOVATIONS, CARDINAL INNOVATIONS reserves the right to take action to collect the outstanding balance from the CONTRACTOR. b. If CARDINAL INNOVATIONS or CONTRACTOR determines CONTRACTOR has received revenues as a result of an error or omission, CARDINAL INNOVATIONS will consult with the CONTRACTOR on preferred method of repayment to CARDINAL INNOVATIONS. If the CONTRACTOR fails to repay CARDINAL INNOVATIONS within the specified period, CARDINAL INNOVATIONS will recoup the amount owed to CARDINAL INNOVATIONS from current and/or future claims. c. If CARDINAL INNOVATIONS, through an audit or review, determines CONTRACTOR has been paid for a service or a portion of a service that CARDINAL INNOVATIONS determines should have been disallowed, CARDINAL INNOVATIONS will recoup the amount owed to CARDINAL INNOVATIONS from current and/or future claims. If payback amount exceeds outstanding provider claims, CARDINAL INNOVATIONS will invoice CONTRACTOR the amount owed to CARDINAL INNOVATIONS. CONTRACTOR shall have thirty (30) calendar days from the invoice date to pay back the total amount owed. If CONTRACTOR fails to repay funds identified as requiring payback CARDINAL INNOVATIONS, then CARDINAL INNOVATIONS reserves the right to take action to collect the outstanding balance from the CONTRACTOR. d. At its sole discretion CARDINAL INNOVATIONS may establish a payment plan with CONTRACTOR for repayment of funds as noted above in 3.a, 3.b, and 3.c of Article VI. e. If CARDINAL INNOVATIONS, through an audit or review, determines CONTRACTOR has been paid for a claim that was fraudulently billed to CARDINAL INNOVATIONS, CARDINAL INNOVATIONS will recoup the amount owed to CARDINAL INNOVATIONS from current and/or future claims. If payback amount exceeds outstanding provider claims, CARDINAL INNOVATIONS will invoice CONTRACTOR the amount owed to CARDINAL INNOVATIONS. CONTRACTOR shall have thirty (30) calendar days from the invoice date to pay back the total amount owed. Fraudulent billing may include, but is not limited to, unbundling services, billing for services by non-credentialed or non-licensed staff, or billing for a service that CONTRACTOR never rendered or for which documentation is absent or inadequate. f. Requests for Reconsideration by CARDINAL INNOVATIONS and Appeals of payback determinations are outlined in detail in "Section XIII: Reconsideration Review Process for Providers" of the Cardinal Innovations Healthcare Provider Manual.

Paybacks. a. If CARDINAL INNOVATIONS LME determines CONTRACTOR Contractor has failed to comply with State, Federal, Medicaid or any other CARDINAL INNOVATIONS’ LME revenue source requirements, CARDINAL INNOVATIONS LME will recoup the amount owed to CARDINAL INNOVATIONS LME from current and/or future claims. If payback amount exceeds outstanding provider claims, CARDINAL INNOVATIONS the LME will invoice CONTRACTOR Contractor the amount owed to CARDINAL INNOVATIONSLME. CONTRACTOR Contractor shall have thirty (30) calendar days from the invoice date to pay back the total amount owed. If CONTRACTOR Contractor fails to repay funds identified as requiring payback to CARDINAL INNOVATIONSthe LME, CARDINAL INNOVATIONS the LME reserves the right to take action to collect the outstanding outstand balance from the CONTRACTORContractor. b. If CARDINAL INNOVATIONS LME or CONTRACTOR Contractor determines CONTRACTOR Contractor has received revenues as a result of an error or omission, CARDINAL INNOVATIONS the LME will consult with the CONTRACTOR Contractor on preferred method of repayment to CARDINAL INNOVATIONSthe LME. If the CONTRACTOR Contractor fails to repay CARDINAL INNOVATIONS the LME within the specified period, CARDINAL INNOVATIONS the LME will recoup the amount owed to CARDINAL INNOVATIONS LME from current and/or future claims. c. If CARDINAL INNOVATIONSLME, through an audit or review, determines CONTRACTOR Contractor has been paid for a service or a portion of a service that CARDINAL INNOVATIONS LME determines should have been disallowed, CARDINAL INNOVATIONS LME will recoup the amount owed to CARDINAL INNOVATIONS LME from current and/or future claims. If payback amount exceeds outstanding provider claims, CARDINAL INNOVATIONS the LME will invoice CONTRACTOR Contractor the amount owed to CARDINAL INNOVATIONSLME. CONTRACTOR Contractor shall have thirty (30) calendar days from the invoice date to pay back the total amount owed. If CONTRACTOR Contractor fails to repay funds identified as requiring payback CARDINAL INNOVATIONSto the LME, then CARDINAL INNOVATIONS the LME reserves the right to take action to collect the outstanding balance from the CONTRACTORContractor. d. At its sole discretion CARDINAL INNOVATIONS the LME may establish a payment plan with CONTRACTOR Contractor for repayment of funds as noted above in 3.a, 3.b, and 3.c of Article VI. e. If CARDINAL INNOVATIONSLME, through an audit or review, determines CONTRACTOR Contractor has been paid for a claim that was fraudulently billed to CARDINAL INNOVATIONSLME, CARDINAL INNOVATIONS LME will recoup the amount owed to CARDINAL INNOVATIONS LME from current and/or future claims. If payback amount exceeds outstanding provider claims, CARDINAL INNOVATIONS the LME will invoice CONTRACTOR Contractor the amount owed to CARDINAL INNOVATIONSLME. CONTRACTOR Contractor shall have thirty (30) calendar days from the invoice date to pay back the total amount owed. Fraudulent billing may include, but is not limited to, unbundling services, billing for services by non-credentialed or non-licensed staff, or billing for a service that CONTRACTOR never rendered or for which documentation is absent or inadequate. f. Requests for Reconsideration by CARDINAL INNOVATIONS and Appeals of payback determinations are outlined in detail in "Section XIII: Reconsideration Review Process for Providers" of the Cardinal Innovations Healthcare Provider Manual.thirty