Billing and Reimbursement. 1. It is the CONTRACTOR’s responsibility to verify the Enrollee’s Medicaid coverage prior to submitting claims to the LME/PIHP. If an individual presents for services who is not eligible for Medicaid and the CONTRACTOR reasonably believes that the individual meets Medicaid financial eligibility requirements, CONTRACTOR shall offer to assist the Enrollee in applying for Medicaid.
Billing and Reimbursement. Beginning December 20, 2013, OEWD shall send invoices to Alliance once every two months for the amounts to be paid pursuant to the contract. On or before May 20, 0000, XXXX shall invoice Alliance for all amounts owed through April 30, 2014 in order to meet federal fiscal year deadlines. OEWD may submit invoices for unreimbursed services provided prior to December 1, 2013, consistent with this program with appropriate documentation. OEWD agrees and understands that it is solely responsible for payment of income, social security, and other employment taxes due to the proper taxing authorities, and Alliance will not deduct such taxes from any payments made hereunder. OEWD shall submit an itemized invoice to Alliance no later than the 20th calendar day of the month following the prior two-month period during which Services were performed. Invoices must be on letterhead, include a detailed accounting of hours and services provided, shall reflect the above budget, be accompanied with copies of ledger pages reflecting charges and any supporting documentation, include any additional information as maybe reasonably requested by Alliance, and should be sent to the following address: Alliance Behavioral Healthcare Attention: Accounts Payable 0000 Xxxxxxx Xxxxxxxxx, Xxxxx 000 Xxxxxx, XX 00000 xxxxxxxxxxxxxxx@xxxxxxxxxxx.xxx Failure to submit the required invoice as specified above may result in non-payment. Payment will be processed to OEWD within twenty (20) business days of receipt and approval of the invoice by Alliance.
Billing and Reimbursement. These Policies and Procedures shall be designed to ensure that Parkland complies with the Federal health care programs requirements on billing and reimbursement, shall be implemented within 90 days after the Effective Date, and shall include the following:
Billing and Reimbursement. It is the CONTRACTOR’s responsibility to verify the Enrollee’s Medicaid coverage prior to submitting claims to the LME/PIHP. If an individual presents for services who is not eligible for Medicaid and the CONTRACTOR reasonably believes that the individual meets Medicaid financial eligibility requirements, CONTRACTOR shall offer to assist the individual in applying for Medicaid. The LME/PIHP Medicaid reimbursement rate can be revised unilaterally by the Department at any time. The LME/PIHP may unilaterally revise reimbursement rates under this contract with 30 days’ notice. CONTRACTOR shall comply with all terms of this Contract even though a third party agent may be involved in billing the claims to the LME/PIHP. It is a material breach of the Contract to assign the right to payment under this Contract to a third party in violation of Controlling Authority, specifically 42 C.F.R. §447.10. CONTRACTOR acknowledges that the LME/PIHP and this Contract covers only those Medicaid-reimbursable, and state and/or federal block grant funded, MH/DD/SA services listed in Attachment A, and does not cover other services outlined in the North Carolina State Plan for Medical Assistance. The CONTRACTOR may xxxx any such other services for Medicaid recipients directly to the North Carolina Medicaid program. CONTRACTOR further understands that there are circumstances that may cause an Enrollee to be disenrolled from or by the LME/PIHP. If the disenrollment arises from Enrollee’s loss of Medicaid eligibility, the LME/PIHP shall be responsible for claims for the Enrollee up to and including the Enrollee’s last day of eligibility. If the disenrollment arises from a change in the Enrollee’s Medicaid county of residence, LME/PIHP shall be responsible for claims for Enrollee up to the effective date of date of the change in Medicaid county of residence. In any instance of Enrollee’s disenrollment, preexisting authorizations will remain valid for any services actually rendered prior to the date of disenrollment. CONTRACTOR shall xxxx LME/PIHP for all MH/DD/SA services as listed in Attachment A provided to Enrollees who reside in the LME/PIHP catchment area. Unless otherwise indicated, LME/PIHP will pay the CONTRACTOR the lesser of the CONTRACTOR’s current usual and customary charges or the LME/PIHP established rate for services.
Billing and Reimbursement. HOMELINK shall pay Provider for services according to the condition and terms described in Exhibit B. In no event shall Provider xxxx, charge, collect a deposit from, seek compensation, remuneration or reimbursement from or have any recourse against patients or any persons other than HOMELINK or any applicable third party payer for services provided pursuant to this Agreement.
Billing and Reimbursement. 1. Except for Emergency Services, Provider must verify the Member’s Medicaid coverage in accordance with the Provider Manual prior to providing Covered Services or submitting claims to Alliance. Provider shall offer to assist any Member(s) who the Provider reasonably believes meet Medicaid eligibility requirements in applying for Medicaid. Alliance provides Member eligibility information through Alliance’s provider portal and other means. For Emergency Services, Providers shall verify Member eligibility no later than the next business day after the Member is stabilized or the Provider learning the individual may be a Member, whichever is later. Members’ eligibility status is subject to retroactive disenrollment, and Alliance may, unless prohibited by Laws and Program Requirements, recoup payments for items or services provided to such individuals after the effective date of disenrollment even if such items and services were authorized by Alliance.
Billing and Reimbursement. 1. It is the LIP’s responsibility to verify the Enrollee’s Medicaid coverage prior to submitting claims to the LME/PIHP. If an individual presents for services who is not eligible for Medicaid and the LIP reasonably believes that the individual meets Medicaid financial eligibility requirements, LIP shall refer the Individual to Division of Social Services to apply for Medicaid.
Billing and Reimbursement. 4.1 Each Ride DuPage to Work Partner will be responsible for paying Pace one hundred percent (100%) of its monthly costs, which is based on monthly ridership, upon receipt of a monthly Ride DuPage to Work invoice from Pace. Each Partner will be solely responsible for the payment(s) described above. No Partner shall be responsible for another Partner’s payment obligations for the Ride DuPage to Work Program unless agreed to in writing through a separate agreement.
Billing and Reimbursement. Physician agrees to engage in appropriate billing practices and accept reimbursement in accordance with the physician’s Network Vendor contractual requirements. Physician agrees to not negotiate payment above the contracted rate, including but not limited to requesting letters of agreement for prearranged fees for services rendered. Physician will not file liens for balance between the contracted rate and either the Official Medical Fee Schedule (OMFS) or the Resource Based Relative Value Scale (RBRVS). All disputes regarding the amount of payment allowed by the Network Vendor contract shall be submitted to State Fund for an appeal. If, after the appeal, there is still a dispute, physician must submit the dispute to Independent Xxxx Review (IBR) under Labor Code section 4603.6 in accordance with the physician’s Network Vendor contract agreement. Physician further agrees to provide all documents required to participate in IBR, including but not limited to, physician’s Network Vendor contract’s rate sheet. To expedite reimbursements, State Fund encourages all MPN physicians to utilize e-billing with the expectation that this process will comply with all e-billing standards promulgated by the DWC.
Billing and Reimbursement. Medically Home shall pay Provider for services, equipment and supplies in accordance with the fee schedule depicted on Exhibit B, attached hereto and incorporated herein. Provider is to xxxx Medically Home within thirty (30) days of service. Medically Home will send payment to Provider within 45 days after Medically Home receives Provider’s invoice.
