Payment Requirements/Procedures Sample Clauses

Payment Requirements/Procedures. The HMO is responsible for the payment of all contract services provided to all BadgerCare Plus and/or Medicaid SSI members listed as ADDs or CONTINUEs on either the Initial or Final Enrollment Reports generated for the coverage period for BadgerCare Plus – Standard, Benchmark, Core Plans and for Medicaid SSI. The HMO is also responsible for the provision, or authorizing the provision of, services to all members with valid ForwardHealth ID cards indicating HMO enrollment, without regard to disputes about enrollment status and without regard to any other identification requirements. Any discrepancies between the cards and the enrollment reports must be reported to the Department for resolution. The HMO must continue to provide and authorize provision of all contract services until the discrepancy is resolved, including members who were PENDING on the Initial Report and held a valid ForwardHealth ID card indicating HMO enrollment, but did not appear as a CONTINUE on the Final Report. If a member shows on the Initial enrollment report as pending and later shows on the Final report as a disenroll, the HMO will not be liable for services after the date the disenrollment is effective. The payment for services to all newborns meeting the criteria described in the section “Capitation Payment for Newborns.”
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Payment Requirements/Procedures. The HMO is responsible for the payment of all contract services provided to all BadgerCare Plus and/or Medicaid SSI members listed as ADDs or CONTINUEs on either the Initial or Final Enrollment Reports generated for the month of coverage. The HMO is also responsible for the provision, or authorizing the provision of, services to all enrollees with valid Forward cards indicating HMO enrollment, without regard to disputes about enrollment status and without regard to any other identification requirements. Any discrepancies between the cards and the enrollment reports must be reported to the Department for resolution. The HMO must continue to provide and authorize provision of all contract services until the discrepancy is resolved, including members who were PENDING on the Initial Report and held a valid Forward card indicating HMO enrollment, but did not appear as a CONTINUE on the Final Report. The payment for services to all newborns meeting the criteria described in the section “Capitation Payment for Newborns.”
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Payment Requirements/Procedures. The PIHP is responsible for the payment of all contract services provided to all FCMH members listed as ADDs or CONTINUEs on either the Initial or Final Enrollment Rosters provided by the Department for the coverage month. The PIHP is responsible for the provision, or authorizing the provision of, services to all FCMH members with valid ForwardHealth ID cards indicating PIHP enrollment, without regard to disputes about enrollment status and without regard to any other identification requirements. Any discrepancies between eligibilityand the enrollment rosters must be reported to the Department for resolution. The PIHP must continue to provide and authorize provision of all contract services until the discrepancy is resolved.
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Payment Requirements/Procedures. The HMO is responsible for the payment of all contract services provided to all Medicaid and BadgerCare recipients listed as ADDs or CONTINUEs on either the Initial or Final Enrollment Reports (see Article V, B, D and E) generated for the month of coverage. The HMO is also responsible for: • The payment for services to all newborns meeting the criteria described in Article VI, F, “Capitation Payments for Newborns.” • The provision, or authorizing the provision of, services to all Medicaid enrollees with valid Forward cards indicating HMO enrollment, without regard to disputes about enrollment status and without regard to any other identification requirements. Any discrepancies between the cards and the enrollment reports must be reported to the Department for resolution. The HMO must continue to provide and authorize provision of all contract services until the discrepancy is resolved, including recipients who were PENDING on the Initial Report and held a valid Forward card indicating HMO enrollment, but did not appear as a CONTINUE on the Final Report.
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Related to Payment Requirements/Procedures

  • Payment Requirements ‌ A. Contract Amount: It is expressly agreed and understood that the total amount to be paid by County under this Contract shall not exceed the total County funding as set forth in Attachment B-Payment/Compensation to Subrecipient attached hereto and incorporated herein by reference. B. County will reclaim any unused balance of funds for reallocation to other County approved projects.

  • Basic Requirements To be eligible for PayPal’s Seller Protection program, all of the following basic requirements must be met, as well as any applicable additional requirements: • The primary address for your PayPal account must be in the United States. • The item must be a physical, tangible good that can be shipped, except for items subject to the Intangible Goods Additional Requirements. Transactions involving items that you deliver in person in connection with payment made in your physical store, may also be eligible for PayPal’s Seller Protection program so long as the buyer paid for the transaction in person by using a PayPal goods and services QR code. • You must ship the item to the shipping address on the Transaction Details page in your PayPal account for the transaction. If you originally ship the item to the recipient’s shipping address on the Transaction Details page but the item is later redirected to a different address, you will not be eligible for PayPal’s Seller Protection program. We therefore recommend not using a shipping service that is arranged by the buyer, so that you will be able to provide valid proof of shipping and delivery. • The shipping requirement does not apply to eligible transactions involving items that you deliver in person; provided, however, that you agree to provide us with alternative evidence of delivery or such additional documentation or information relating to the transaction that we may request. • You must respond to PayPal’s requests for documentation and other information in a timely manner as requested in our email correspondence with you or in our correspondence with you through the Resolution Center. If you do not respond to PayPal’s request for documentation and other information in the time requested, you may not be eligible for PayPal’s Seller Protection program. • If the sale involves pre-ordered or made-to-order goods, you must ship within the timeframe you specified in the listing. Otherwise, it is recommended that you ship all items within 7 days after receipt of payment. • You provide us with valid proof of shipment or delivery. • The payment must be marked “eligible” or “partially eligible” in the case of Unauthorized Transaction claims, or “eligible” in the case of Item Not Received claims, for PayPal’s Seller Protection program on the Transaction Details page. • In the case of an Unauthorized Transaction claim, you must provide valid proof of shipment or proof of delivery that demonstrates that the item was shipped or provided to the buyer no later than two days after PayPal notified you of the dispute or reversal. For example, if PayPal notifies you of an Unauthorized Transaction claim on September 1, the valid proof of shipment must indicate that the item was shipped to the buyer no later than September 3 to be eligible for PayPal’s Seller Protection program. PayPal determines, in its sole discretion, whether your claim is eligible for PayPal’s Seller Protection program. PayPal will make a decision, in its sole discretion, based on the eligibility requirements, any information or documentation provided during the resolution process, or any other information PayPal deems relevant and appropriate under the circumstances. To be eligible for PayPal’s Seller Protection program for a buyer’s Item Not Received claim, you must meet both the basic requirements and the additional requirements listed below: • Where a buyer files a chargeback with the issuer for a card-funded transaction, the payment must be marked “eligible” for PayPal’s Seller Protection on the Transaction Details page. • You must provide proof of delivery as described below.

  • Project Requirements 1. Project must conform to regulations under 24 CFR Part 92, commonly known as the HOME Regulations.

  • Audit Requirements The Agreement, and any pertinent records involving transactions relating to this Agreement, is subject to the examination and audit of the Auditor General of the State of California or Comptroller General of the United States or designated Federal authority for a period of up to five (5) years after final payment under the Agreement. UC, and if the underlying grant, cooperative agreement or federal contract so provides, the other contracting Party or grantor (and if that be the United States or an instrumentality thereof, then the Comptroller General of the United States) will have access to and the right to examine Supplier’s pertinent books, documents, papers, and records involving transactions and work related to the Agreement until the expiration of five (5) years after final payment under the Agreement. The examination and audit will be confined to those matters connected with the performance of the Agreement, including the costs of administering the Agreement.

  • Deposit Requirements Funds may be deposited to any account in any manner approved by the Credit Union in accordance with the requirements set forth in the “Rate Addendum and Schedule of Fees and Charges.” All accounts are non- assignable and nonnegotiable to third parties. Certificate accounts are governed by the terms of this Agreement, the terms of the “Rate Addendum and Schedule of Fees and Charges,” and the terms and disclosures on your certificate account receipt for each account, which is incorporated herein by this reference.