Denied Sample Clauses
Denied. Rx Solutions will fax a copy of the denied Injectable Authorization Form to the physician’s office. • Rx Solutions will mail a denial letter to the patient’s home. • The patient or physician can request an Appeal as deemed necessary.
Denied if the fee for a procedure or service is Denied and chargeable to the patient, the procedure or service is not a benefit of the patient’s plan. The approved amount is not payable by your plan, but is collectable from the patient.
Denied. The fee for a procedure or service is not a benefit under the plan and is chargeable to the patient. The approved amount is not payable by Delta Dental, but is collectable from the patient.
Denied. As used herein, the term "denied" shall mean a claim or medical procedure that has been adjudicated according to program policies and procedures and found not to be payable.
Denied. (This means one or more tasks/deliverables did not meet the Accepted Criteria identified on the WA and are deemed unacceptable to the DOJ, the WA will be marked as denied by the DOJ.) If a task/deliverable is either approved with noted changes or denied, the DOJ will specify on the FA the reasons specifically noting any portions of the Acceptance Criteria that have not been met. Within five (5) business days from the date of the Contractor’s receipt of notification (cure period) that a WA has been denied (unless a longer period is approved by the DOJ), Contractor must correct the deficiency(s) and bring all tasks/deliverables into compliance. In all cases, and at no additional cost to the DOJ, Contractor must timely and diligently pursue a cure for any deficiencies and must take all reasonable steps, including allocating additional resources, if necessary, to cure any and all deficiencies as promptly as practicable. Nothing herein will affect, alter, or relieve Contractor of its obligations to correct deficiencies or errors in the WA, in accordance with the time response standards set forth herein. If Contractor fails to correct deficiencies in accordance with a cure period, the DOJ may, without prejudice to any other remedy: 1) cure or make good any such deficiencies, including by securing the services of third parties, at Contractor’s sole expense; and 2) require Contractor to suspend services immediately with regard to the deliverable until the deficiency has been cured. As appropriate, a revised estimate will be issued deducting from the payments then or thereafter due Contractor for the cost of correcting or finishing such deficiencies, including the cost of additional services and third- party services. Any additional cost in the revised CO will be borne by Contractor. Once Contractor has corrected a deficiency, Contractor must re-submit the invoice to the DOJ for approval. Upon receipt of such invoice, the DOJ will determine whether the deficiency specified in the rejection notice has been corrected. This subsequent review will be limited to the original deficiencies and the portions of the deliverable(s) that were dependent on the deficiencies. If any tasks/deliverables are again found to be unacceptable, the process described herein will be repeated until: • All tasks/deliverables are accepted by the DOJ; or • DOJ terminates the Agreement or WA; or • The DOJ and Contractor mutually agree to a revised CO, created under this Agreement