Payments to Providers Sample Clauses

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Payments to Providers. Payments to Preferred Providers shall be made by UHS on behalf of the City in accordance with the terms of the agreements with those providers and, except to the extent the Health Service is subject to coordination of benefits and/or subrogation recovery, shall be billed to City in accordance with Exhibit D. Health Services subject to coordination of benefits and/or a subrogation recovery shall be billed to City in accordance with the Preferred Provider's Customary Charges after any copayments and/or deductibles have been applied. City acknowledges that there may be arrangements with providers or suppliers of pharmacy Health Services under which UHS or its affiliates may receive and retain payments from those providers or suppliers in return for services. UHS, as soon as administratively possible at the end of each Plan year, will provide City with an accounting of the amounts received from providers or suppliers of pharmacy Health Services. Non-Preferred Providers shall be paid by City according to the terms and conditions of the Plan. In the event that a dispute arises between City and any provider regarding payment of a claim, City shall promptly inform UHS of the dispute and UHS shall use reasonable efforts to facilitate resolution of the dispute.
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Payments to Providers. Payments shall not be made on behalf of an enrollee to providers of health care services other than the contractor for the benefits covered in Article Four and rendered during the term of this contract.
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Payments to Providers. Except as provided under federal regulation 42 CFR §§447.56(c)(2) and (c)(3), each MCO must reduce the payment it makes to a provider by the amount of a beneficiary's copayment obligation, regardless of whether the provider has collected the copayment or has waived the copayment. Where the MCO contracts a provider on a capitated basis, the beneficiary’s copayment obligation is taken into account in calculating capitated rates.
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Payments to Providers. For purposes of this Agreement, timely payment shall mean payment by the earlier of (i) thirty (30) days after Medical Group's receipt of a clean claim, or (ii) such other period as is specified by applicable state or federal law or regulation (3) the time specified in the applicable Medical Group Subcontract. For purposes of this Section 3.13.1 and Section 3.13.2, a clean claim is one in which Medical Group has received the complete claim and all information necessary to determine liability for the claim. Medical Group shall provide, at PacifiCare's request, claims reports in a form to be mutually agreed upon by the parties.
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Payments to Providers 
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  • Agreements with Subcontractors Business Associate shall enter into a Business Associate Agreement with any Subcontractor to whom it provides PHI received from Covered Entity or created or received by Business Associate on behalf of Covered Entity in which the Subcontractor agrees to the same restrictions and conditions that apply through this Agreement to Business Associate with respect to such PHI. Business Associate must enter into this Business Associate Agreement before any use by or disclosure of PHI to such agent. The written agreement must identify Covered Entity as a direct and intended third party beneficiary with the right to enforce any breach of the agreement concerning the use or disclosure of PHI. Business Associate shall provide a copy of the Business Associate Agreement it enters into with a subcontractor to Covered Entity upon request. Business associate may not make any disclosure of PHI to any Subcontractor without prior written consent of Covered Entity.

  • Agreement to Provide Services ▇▇▇▇▇▇▇ Sachs hereby engages the Contract Underwriter, and the Contract Underwriter hereby agrees, to provide the following Services: (a) establish and maintain (or assist the Company in establishing and maintaining) relationships with owners of Contracts who are its customers or customers of other broker-dealers with whom it has entered into agreements to sell the Contracts (“Selling Dealers”); (b) provide Contract owners with “personal services” (within the meaning of NASD Conduct Rule 2830(b)(9)); (c) assist in the preparation of advertisements and other sales literature for the Contracts that describes or discusses the Funds; (d) provide sales compensation to representatives of the Contract Underwriter; (e) pay money to Selling Dealers for any of the foregoing purposes; and (f) perform any additional services primarily intended to result in the distribution of the Contracts and the sale of the Service Shares to the Company.