Common use of Claims Adjudication Clause in Contracts

Claims Adjudication. Health Plan or its designee shall receive, process and pay in a timely manner claims for Covered Services rendered or authorized by Practitioners in accordance with the authorization procedures as set forth in the Provider Manual. Health Plan shall ensure that Clean Claims are adjudicated promptly in accordance with applicable statutory and regulatory requirements. Health Plan shall work diligently with Provider and Practitioner to resolve any perceived lack of timeliness with regard to claims payment under this Agreement.

Appears in 3 contracts

Samples: Provider Group Affiliation Agreement, Provider Group Affiliation Agreement, Provider Group Affiliation Agreement

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Claims Adjudication. Health Plan or its designee shall receive, process and pay in a timely manner claims for Covered Services rendered or authorized by Practitioners Provider in accordance with the authorization procedures as set forth in the Provider Manual. Health Plan shall ensure that Clean Claims are adjudicated promptly in accordance with applicable statutory and regulatory requirements. Health Plan shall work diligently with Provider and Practitioner to resolve any perceived lack of timeliness with regard to claims payment under this Agreement.

Appears in 3 contracts

Samples: Practitioner Affiliation Agreement, Practitioner Affiliation Agreement, Ancillary Provider Affiliation Agreement

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Claims Adjudication. Health Plan or its designee shall receive, process process, and pay in a timely manner claims for Covered Services rendered or authorized by Practitioners Provider in accordance with the authorization procedures as set forth in the Provider Manual. Health Plan shall ensure that Clean Claims are adjudicated promptly in accordance with applicable statutory and regulatory requirements. Health Plan shall work diligently with Provider and Practitioner to resolve any perceived lack of timeliness with regard to claims payment under this Agreement.

Appears in 2 contracts

Samples: Blue Cross Complete of Michigan Practitioner Affiliation Agreement, Blue Cross Complete of Michigan Ancillary Provider Affiliation Agreement

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