Common use of Third Party Billing Clause in Contracts

Third Party Billing. The Managing Entity shall adhere to the following guidelines for payment of services billed by Network Service Providers: 2.9.1 Department funds may not reimburse services provided to: 2.9.1.1 Individuals who have third party insurance coverage when the services provided are paid under the insurance plan; or 2.9.1.2 Medicaid enrollees or recipients of another publicly funded health benefits assistance program, when the services provided are paid by said program.

Third Party Billing. The Managing Entity shall adhere to the following guidelines for payment of services billed by Network Service Providers: 2.9.1 Department funds may not reimburse services provided to: 2.9.1.1 Individuals who have third party insurance coverage when the services provided are paid under the insurance plan; or 2.9.1.2 Medicaid enrollees or recipients of another publicly publically funded health benefits assistance program, when the services provided are paid by said program.