Common use of Validation Review Clause in Contracts

Validation Review. In the event OIG has reason to believe that: (a) any Claims Review fails to conform to the requirements of this CIA; or (b) the IRO’s findings or Claims Review results are inaccurate, OIG may, at its sole discretion, conduct its own review to determine whether the Claims Review complied with the requirements of the CIA and/or the findings or Claims Review results are inaccurate (Validation Review). Trans-Star shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents so long as it is initiated within one year after Trans- Star’s final submission (as described in Section II) is received by OIG. Prior to initiating a Validation Review, OIG shall notify Trans-Star in writing of its intent to conduct a Validation Review and the reasons OIG has determined a Validation Review is necessary. Trans-Star shall have up to 30 days following the date of the OIG’s written notice to submit a written response to OIG that includes any additional or relevant information to clarify the results of the Claims Review or to correct the inaccuracy of the Claims Review and/or to propose alternatives to the proposed Validation Review. OIG will attempt in good faith to resolve any Claims Review issues with Trans-Star prior to conducting a Validation Review. However, the final determination as to whether or not to proceed with a Validation Review shall be made at the sole discretion of OIG.

Validation Review. In the event OIG has reason to believe that: (a) any Claims Review fails to conform to the requirements of this CIA; or (b) the IRO’s findings or Claims Review results are inaccurate, OIG may, at its sole discretion, conduct its own review to determine whether the Claims Review complied with the requirements of the CIA and/or the findings or Claims Review results are inaccurate (Validation Review). Trans-Star La Fuente shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents so long as it is initiated within one year after Trans- StarLa Fuente’s final submission (as described in Section II) is received by OIG. Prior to initiating a Validation Review, OIG shall notify Trans-Star La Fuente in writing of its intent to conduct a Validation Review and the reasons OIG has determined a Validation Review is necessary. Trans-Star La Fuente shall have up to 30 days following the date of the OIG’s written notice to submit a written response to OIG that includes any additional or relevant information to clarify the results of the Claims Review or to correct the inaccuracy of the Claims Review and/or to propose alternatives to the proposed Validation Review. OIG will attempt in good faith to resolve any Claims Review issues with Trans-Star La Fuente prior to conducting a Validation Review. However, the final determination as to whether or not to proceed with a Validation Review shall be made at the sole discretion of OIG.

Validation Review. In the event OIG has reason to believe that: (a) any Claims Review fails to conform to the requirements of this CIA; or (b) the IRO’s findings or Claims Review results are inaccurate, OIG may, at its sole discretion, conduct its own review to determine whether the Claims Review complied with the requirements of the CIA and/or the findings or Claims Review results are inaccurate (Validation Review). Trans-Star Southern States shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents so long as it is initiated within one year after Trans- Star’s Southern States’ final submission (as described in Section II) is received by OIG. Prior to initiating a Validation Review, OIG shall notify Trans-Star Southern States in writing of its intent to conduct a Validation Review and the reasons OIG has determined a Validation Review is necessary. Trans-Star Southern States shall have up to 30 days following the date of the OIG’s written notice to submit a written response to OIG that includes any additional or relevant information to clarify the results of the Claims Review or to correct the inaccuracy of the Claims Review and/or to propose alternatives to the proposed Validation Review. OIG will attempt in good faith to resolve any Claims Review issues with Trans-Star Southern States prior to conducting a Validation Review. However, the final determination as to whether or not to proceed with a Validation Review shall be made at the sole discretion of OIG.

Validation Review. In the event OIG has reason to believe that: (a) any Claims Review fails to conform to the requirements of this CIA; or (b) the IRO’s findings or Claims Review results are inaccurate, OIG may, at its sole discretion, conduct its own review to determine whether the Claims Review complied with the requirements of the CIA and/or the findings or Claims Review results are inaccurate (Validation Review). TransTri-Star County shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents so long as it is initiated within one year after Trans- StarTri- County’s final submission (as described in Section II) is received by OIG. Prior to initiating a Validation Review, OIG shall notify TransTri-Star County in writing of its intent to conduct a Validation Review and the reasons OIG has determined a Validation Review is necessary. TransTri-Star County shall have up to 30 days following the date of the OIG’s written notice to submit a written response to OIG that includes any additional or relevant information to clarify the results of the Claims Review or to correct the inaccuracy of the Claims Review and/or to propose alternatives to the proposed Validation Review. OIG will attempt in good faith to resolve any Claims Review issues with TransTri-Star County prior to conducting a Validation Review. However, the final determination as to whether or not to proceed with a Validation Review shall be made at the sole discretion of OIG.

Validation Review. In the event OIG has reason to believe that: (a) any Claims Review fails to conform to the requirements of this CIA; or (b) the IRO’s findings or Claims Review results are inaccurate, OIG may, at its sole discretion, conduct its own review to determine whether the Claims Review complied with the requirements of the CIA and/or the findings or Claims Review results are inaccurate (Validation Review). Trans-Star PALMS shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents so long as it is initiated within one year after Trans- StarPALMS’s final submission (as described in Section II) is received by OIG. Prior to initiating a Validation Review, OIG shall notify Trans-Star PALMS in writing of its intent to conduct a Validation Review and the reasons OIG has determined a Validation Review is necessary. Trans-Star PALMS shall have up to 30 days following the date of the OIG’s written notice to submit a written response to OIG that includes any additional or relevant information to clarify the results of the Claims Review or to correct the inaccuracy of the Claims Review and/or to propose alternatives to the proposed Validation Review. OIG will attempt in good faith to resolve any Claims Review issues with Trans-Star PALMS prior to conducting a Validation Review. However, the final determination as to whether or not to proceed with a Validation Review shall be made at the sole discretion of OIG.

Validation Review. In the event OIG has reason to believe that: (a) any Claims Review fails to conform to the requirements of this CIA; or (b) the IRO’s findings or Claims Review results are inaccurate, OIG may, at its sole discretion, conduct its own review to determine whether the Claims Review complied with the requirements of the CIA and/or the findings or Claims Review results are inaccurate (Validation Review). Trans-Star Ocean Dental shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents so long as it is initiated within one year after Trans- StarOcean Dental’s final submission (as described in Section II) is received by OIG. Prior to initiating a Validation Review, OIG shall notify Trans-Star Ocean Dental in writing of its intent to conduct a Validation Review and the reasons OIG has determined a Validation Review is necessary. Trans-Star Ocean Dental shall have up to 30 days following the date of the OIG’s written notice to submit a written response to OIG that includes any additional or relevant information to clarify the results of the Claims Review or to correct the inaccuracy of the Claims Review and/or to propose alternatives to the proposed Validation Review. OIG will attempt in good faith to resolve any Claims Review issues with Trans-Star Ocean Dental prior to conducting a Validation Review. However, the final determination as to whether or not to proceed with a Validation Review shall be made at the sole discretion of OIG.

Validation Review. In the event OIG has reason to believe that: (a) any Claims Review fails to conform to the requirements of this CIA; or (b) the IRO’s findings or Claims Review results are inaccurate, OIG may, at its sole discretion, conduct its own review to determine whether the Claims Review complied with the requirements of the CIA and/or the findings or Claims Review results are inaccurate (Validation Review). Trans-Star The Providers shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents so long as it is initiated within one year after Trans- Star’s the Providers’ final submission (as described in Section II) is received by OIG. Prior to initiating a Validation Review, OIG shall notify Trans-Star the Providers in writing of its intent to conduct a Validation Review and the reasons OIG has determined a Validation Review is necessary. Trans-Star The Providers shall have up to 30 days following the date of the OIG’s written notice to submit a written response to OIG that includes any additional or relevant information to clarify the results of the Claims Review or to correct the inaccuracy of the Claims Review and/or to propose alternatives to the proposed Validation Review. OIG will attempt in good faith to resolve any Claims Review issues with Trans-Star the Providers prior to conducting a Validation Review. However, the final determination as to whether or not to proceed with a Validation Review shall be made at the sole discretion of OIG.