Reimbursement Terms Clause Samples

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Reimbursement Terms. The Contract must provide a complete description of the payment method or payment amounts applicable to a provider. The MCO provider Contract or provider manual must explain to providers how to submit a clean claim including a complete listing of all required information, including claims coding and processing guidelines for the applicable provider type. The MCO provider must understand and agree that BMS is not liable or responsible for payment for covered services rendered pursuant to the MCO provider contract;
Reimbursement Terms. Based on the estimated Project Cost of $1,608,849.00, and the Grantee’s Match participation rate of 68.92%, the reimbursement rate will be 31.08%. Upon successful completion of the Project, and of the requirements set forth in the “Retention” and “Final Report and Request for Reimbursement” sections below, and receipt by OPRD of the final reimbursement request, the State will pay Grantee the remaining Grant Funds balance, or 31.08% of the total cost of the Project, whichever is less.
Reimbursement Terms. The total estimated project cost is included in the grant agreement. Subject to and in accordance with the terms and conditions of this Agreement, OPRD shall provide Grant Funds to Grantee for the project in an amount not to exceed the amount awarded in the grant agreement, whichever is less, for eligible costs of work completed. Grantee shall accept the Grant Funds and provide Match Funds for the Project as required by the grant.
Reimbursement Terms. The Department shall reimburse the Contractor for Suitable Representative Functions under the following limitations. a. The Department will reimburse: 1. Up to thirty-two (32) units per Calculated Budget appeal in connection with the Client’s initial Calculated Budget determination or Calculated Budget determination for purposes of annual redetermination, billable for an assigned initial referral commencing from the Contractor’s first contact with the Client. In case of documented attempts by the Contractor to contact the Client that resulted in initial referral closure due to inability to establish or maintain contact with the Client, the Department will pay one (1) unit. Following initial contact, appeal assistance will commence with the first fifteen (15) minute unit of billable activity. Appeal assistance services include, but are not limited to: i. Helping the Client submit an Appeal Request Form to begin the process to appeal the Client’s Calculated Budget. ii. Helping the Client prepare for Informal Review, Extended Informal Review, and Fair Hearings for Calculated Budget appeals. iii. Participating in an Informal Review, Extended Informal review, Fair Hearing, or one or more of these reviews or hearings, to advocate for the Client regarding the Client’s Calculated Budget.
Reimbursement Terms. If the Service Provider violates or breaches contract terms, the ESHP office must be notified and the Service Provider may be excluded from participating in future ESHP projects. In addition, reimbursement may be withheld from the Owner until contract requirements are satisfied.
Reimbursement Terms. If the Service Provider violates or breaches contract terms, the SHOP office must be notified and the Service Provider may be excluded from participating in future SHOP projects. In addition, reimbursement may be withheld from the Owner until contract requirements are satisfied.
Reimbursement Terms. A. For the following services, DMS shall reimburse ADH at a rate equal to the physicians’ fee schedule. The rates are subject to change according to revisions made to that schedule. 1. Family Planning Services 2. Well Woman Services
Reimbursement Terms. Excluding courses that were approved for reimbursement prior to the effective date of this Agreement, the County will reimburse employees for one (1) undergraduate degree and for one (1) graduate degree, if such degree would be beneficial to the employee’s current position or to a future position with the County. The reimbursement procedure shall proceed as follows: 1. Up to 90% of the cost of tuition, required books, and class-associated fees for: ▪ Approved technical or undergraduate level courses up to a maximum of $2,000 per fiscal year, or ▪ Approved graduate level courses up to a maximum of $2,500 per fiscal year. 2. Supplies and other fees and charges will not be reimbursed. 3. Employees shall be entitled to reimbursement if they have complied with all provisions of this Regulation and receive a letter grade of A, B, or C, or a “Pass” grade for “Pass/Fail” courses. 4. Only tuition, required books, and class-associated fees actually incurred by employees are eligible for reimbursement. For example, funds received through grants, scholarships, or other waivers for these expenses will not be eligible for reimbursement. 5. The annual reimbursement shall continue for employees who remain employed until such time as they are reimbursed 90% of the cumulative tuition, books, and class-associated fees incurred by the employee. For example, employees who incur covered educational expenses in the cumulative amount of $10,000 shall be reimbursed $9,000 (90% of the total covered educational expenses) in annual increments of $2,000, over a five year period, provided they remain employed for five years.
Reimbursement Terms. A. The first sentence of paragraph 3.2 of Article IV of AGREEMENT shall be read as follows:
Reimbursement Terms. Based on the estimated Project Cost of $425,706.40 and the Grantee’s Match participation rate of 20.01%, the reimbursement rate will be 79.99% of the total project cost. OPRD may require Grantee to meet the match rate for all expenses submitted in each invoice or may waive the match requirement in the individual invoices but enforce the match as to the total project cost. Upon successful completion of the Project and receipt of the final reimbursement request, the State will pay Grantee the remaining Grant Funds balance, or 79.99% of the total cost of the Project, whichever is less.