Rejecting claims Clause Samples

Rejecting claims. (1) Health NZ may reject all or part of a claim if it believes on reasonable grounds that the Provider has submitted incomplete or inaccurate information, or has not complied with claiming restrictions or requirements. (2) If the claim was submitted by the Due Date, Health NZ will notify the Provider that its claim or a part of its claim has been rejected and the reason for the rejection before the next Claim Period. (3) The Provider may correct and resubmit a claim or part of a claim. (4) If a resubmission results in the Provider owing money to Health NZ, Health NZ may recover that money in accordance with clause D.43. (5) If the Provider corrects and resubmits a claim: (a) before the Final Due Date, it will be paid in accordance with clause D.39; (b) after the Final Due Date, the claim will be treated as a late claim under clauses D.26 to D.28 and, if applicable, will be paid in accordance with clause D.40. (6) An adjustment amount may be paid under this Agreement from time to time, being an amount agreed between the Provider and the Payment Agent or determined by Health NZ, that is to be recovered in respect of an overpayment or reimbursed in respect of an underpayment.
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Rejecting claims. (1) Te Whatu Ora may reject all or part of a claim if it believes on reasonable grounds that the Provider has submitted incomplete or inaccurate information, or has not complied with claiming restrictions or requirements. (2) If the claim was submitted by the Due Date, Te Whatu Ora will notify the Provider that its claim or a part of its claim has been rejected and the reason for the rejection before the next Claim Period. (3) The Provider may correct and resubmit a claim or part of a claim. (4) If a resubmission results in the Provider owing money to Te Whatu Ora, Te Whatu ▇▇▇ may recover that money in accordance with clause D.43. (5) If the Provider corrects and resubmits a claim: (a) before the Final Due Date, it will be paid in accordance with clause D.39; (b) after the Final Due Date, the claim will be treated as a late claim under clauses D.26 to D.28 and, if applicable, will be paid in accordance with clause D.40. (6) An adjustment amount may be paid under this Agreement from time to time, being an amount agreed between the Provider and the Payment Agent or determined by Te Whatu Ora, that is to be recovered in respect of an overpayment or reimbursed in respect of an underpayment.
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Rejecting claims. Rejecting claims (1) The DHB may reject all or part of a claim if it believes on reasonable grounds that the Provider has submitted incomplete or inaccurate information, or has not complied with claiming restrictions or requirements. (2) If the claim was submitted by the Due Date, the DHB will notify the Provider that its claim or a part of its claim has been rejected and the reason for the rejection before the next Claim Period. (3) The Provider may correct and resubmit a claim or part of a claim. (4) If a resubmission results in the Provider owing money to the DHB, the DHB may recover that money in accordance with clause D.43. (5) If the Provider corrects and resubmits a claim: (a) before the Final Due Date, it will be paid in accordance with clause D.39; (b) after the Final Due Date, the claim will be treated as a late claim under clauses D.26 to D.28 and, if applicable, will be paid in accordance with clause D.40. (6) An adjustment amount may be paid under this Agreement from time to time, being an amount agreed between the Provider and the Payment Agent or determined by the DHB, that is to be recovered in respect of an overpayment or reimbursed in respect of an underpayment.
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Related to Rejecting claims

  • Conflicting Claims If conflicting claims or demands are made or asserted with respect to any interest of any Beneficiary in any Exchangeable Shares, including any disagreement between the heirs, representatives, successors or assigns succeeding to all or any part of the interest of any Beneficiary in any Exchangeable Shares, resulting in conflicting claims or demands being made in connection with such interest, then the Trustee shall be entitled, at its sole discretion, to refuse to recognize or to comply with any such claims or demands. In so refusing, the Trustee may elect not to exercise any Voting Rights, Exchange Right or Automatic Exchange Rights subject to such conflicting claims or demands and, in so doing, the Trustee shall not be or become liable to any person on account of such election or its failure or refusal to comply with any such conflicting claims or demands. The Trustee shall be entitled to continue to refrain from acting and to refuse to act until: (a) the rights of all adverse claimants with respect to the Voting Rights, Exchange Right or Automatic Exchange Rights subject to such conflicting claims or demands have been adjudicated by a final judgment of a court of competent jurisdiction and all rights of appeal have expired; or (b) all differences with respect to the Voting Rights, Exchange Right or Automatic Exchange Rights subject to such conflicting claims or demands have been conclusively settled by a valid written agreement binding on all such adverse claimants, and the Trustee shall have been furnished with an executed copy of such agreement certified to be in full force and effect. If the Trustee elects to recognize any claim or comply with any demand made by any such adverse claimant, it may in its discretion require such claimant to furnish such surety bond or other security satisfactory to the Trustee as it shall deem appropriate to fully indemnify it as between all conflicting claims or demands.

  • 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.

  • FALSE CLAIMS Contractor warrants that it shall not, with respect to this Contract, make or present any claim upon or against the Government of the Virgin Islands, or any officer, department, board, commission, or other agency thereof, knowing such claim to be false, fictitious or fraudulent. Contractor acknowledges that making such a false, fictitious, or fraudulent claim is an offense under Virgin Islands law.

  • Submitting False Claims The full text of San Francisco Administrative Code Chapter 21, Section 21.35, including the enforcement and penalty provisions, is incorporated into this Agreement. Pursuant to San Francisco Administrative Code §21.35, any contractor or subcontractor who submits a false claim shall be liable to the City for the statutory penalties set forth in that section. A contractor or subcontractor will be deemed to have submitted a false claim to the City if the contractor or subcontractor: (a) knowingly presents or causes to be presented to an officer or employee of the City a false claim or request for payment or approval;