Coding Guidelines and Fee Schedules Sample Clauses

Coding Guidelines and Fee Schedules. Pursuant to the TX HMO Act §843.321; XXXXX shall ensure that PROVIDER has access, within thirty (30) days of a PROVIDER’s request, to a description and copy of the coding guidelines including any underlying bundling, recoding, or other payment process and fee schedules applicable to PROVIDER. Further, XXXXX shall ensure that PROVIDER is given notice of changes in coding guidelines or fee schedules that are applicable to PROVIDER, at least ninety (90) days prior to the effective date of the change(s), unless such change(s) is required by statute or regulation within a shorter timeframe. XXXXX will not retroactively make changes to coding guidelines or fee schedules. PROVIDER may terminate his/her/its participation hereunder, on or before the thirtieth (30th) day after the PROVIDER receives information under this Section IV.1, and in accordance with the termination provisions contained herein, without penalty or discrimination in other vision care benefit Plans hereunder.
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