Timely Submission of Claims Clause Samples
The "Timely Submission of Claims" clause requires parties to submit any claims, such as requests for payment or notices of additional costs, within a specified period after the event giving rise to the claim occurs. Typically, this clause outlines the exact timeframe for submission and may detail the form and supporting documentation required. Its core function is to ensure that claims are raised and addressed promptly, preventing delays and disputes by providing clear deadlines and procedures for notification.
Timely Submission of Claims. Provider shall submit complete claims to Blue Shield for Covered Services furnished to Members no later than twelve (12) months from the date such Covered Services were furnished by Provider or, if Blue Shield is not the primary payor under the coordination of benefits rules described in Section 3.6 hereof, the date payment or denial is received by Provider from the primary payor. If Provider fails to submit a claim for Covered Services within the time-frames set forth in this Section, Blue Shield may deny payment of the claim. In such event, Provider waives its right to any remedies and to pursue the claim further, and may not initiate a demand for arbitration or other legal action against Blue Shield or pursue the Member for additional payment; provided, however, that Blue Shield shall, upon submission of a Provider Appeal by Provider, consider good cause for late submission of a claim denied as untimely.
Timely Submission of Claims. Provider will file Clean Claims within one calendar year from the date of service or discharge, whichever is applicable. If the claim, including revisions or adjustments, is not submitted by Provider or Member within one calendar year from the date of service or discharge, benefits will not be paid. Claims, including revisions or adjustments, that are not filed by Provider prior to the claim filing limit of one calendar year from date of service or discharge will be the Provider's liability. Provider agrees to provide any additional information which is reasonably necessary to determine benefits and to verify performance under this Agreement.
Timely Submission of Claims. Provider shall submit complete claims to Health Plan for Covered Services furnished to Members no later than twelve (12) months from the date such Covered Services were furnished by Provider or, if Health Plan is not the primary payor under the coordination of benefits rules described in Section 3.6 hereof, the date payment or denial is received by Provider from the primary payor. If Provider fails to submit a claim for Covered Services within the timeframes set forth in this Section, Health Plan may deny payment of the claim. In such event, Provider waives its right to any remedies and to pursue the claim further, and may not initiate a demand for arbitration or other legal action against Health Plan or pursue the Member for additional payment; provided, however, that Health Plan shall, upon submission of a Provider Appeal by Provider, consider good cause for late submission of a claim denied as untimely.
Timely Submission of Claims. Dispute claims must be filed timely for consideration. CenturyTel will only address dispute claims that are filed within 90 calendar days of the date of the Charter bill unless otherwise provided for in this Agreement. 4a Charter is required to make timely payment of undisputed billed amounts. Thus, if Charter identifies a billing dispute and plans to withhold payment of the disputed amount, the dispute must be filed either before payment is rendered or at 4 All references are to those web addresses as comprised as of the Effective Date of this Agreement. the same time payment is submitted. Otherwise, CenturyTel will consider any unpaid charges a default of payment. 4b If Charter identifies a possible billing error after submitting payment of a bill, Charter should file a dispute claim with CenturyTel within the time allowance for filing dispute claims. Dispute claims that are subsequently deemed valid will be credited back to Charter’s account once the review of the claim has been finalized. 4c Billing dispute claims not filed within the time allowance described in this Section will be rejected. 4 Charter’s dispute claims must be filed in accordance with these procedures to be considered. Claims not filed in accordance with these procedures will be rejected without consideration.
Timely Submission of Claims. Participating Facility must file all claims within one (1) year of the date of service for such claim to be deemed timely filed. [42 C.F.R. § 424.44(a)]
Timely Submission of Claims. Participating Facility shall submit timely, complete, and accurate claims to DentaQuest in accordance with all federal, state, and AHCA requirements, and shall promptly submit all other information requested by DentaQuest necessary to make payment to Participating Facility under the Agreement. Participating Facility must file all claims within one (1) year of the date of service for such claims to be deemed timely filed.
Timely Submission of Claims. Participating Practice must file all claims within one (1) year of the date of service for such claim to be deemed timely filed. [42 C.F.R. § 424.44(a)]
Timely Submission of Claims. Participating Practice shall submit timely, complete and accurate claims to DentaQuest in accordance with all federal, state, and Agency requirements, and shall promptly submit all other information requested by DentaQuest necessary to make payment to Participating Practice under the Agreement. Participating Practice must file all claims within one (1) year of the date of service for such claims to be deemed timely filed.
Timely Submission of Claims. The Subcontractor agrees to make all Claims against the Contractor for which the Owner is or may be liable in the same manner and within time allowed for the Contractor to make claims against the Owner after the event giving rise to the claim occurs, and in sufficient time for the Contractor to make such claims against the Owner. Such claims shall be made in writing and comply with this paragraph to be valid. When Contractor pursues a claim against the Owner or its agents that incorporates any Claim on behalf of Subcontractor, each party shall pay the fees of any mediator or arbitrator and the cost of the dispute resolution proceedings in proportion to the amount of the party’s respective claim.
§ 11.6.1 The Subcontractor shall give the Contractor written notice of all Claims not included in the foregoing paragraph within seven (7) calendar days of the date when the Subcontractor knew of the facts giving rise to the event for which the Claim is made; otherwise, such Claims shall not be valid.