Disputed Encounter Submissions Clause Samples

Disputed Encounter Submissions a. On a quarterly basis, the DMAHS will review the Contractor’s file of pharmacy encounters and send a file back to the Contractor of disputed encounters that were identified through the drug rebate invoicing process. b. Within 60 calendar days of receipt of the disputed encounter file from the DMAHS, the Contractor shall, if needed, correct and resubmit any disputed encounters and send a response file that includes 1) corrected and resubmitted encounters as described in the Rebate Section of the HMO Systems Guide, and/or