Common use of Documentation and Recordkeeping Clause in Contracts

Documentation and Recordkeeping. A. Pursuant to PHL § 2557, Vendor shall utilize the Department’s fiscal agent for early intervention claims. Vendor shall provide such information and documentation as required by the Department and necessary for the fiscal agency to carry out its duties. B. Vendor shall utilize a standardized claiming format when claiming for ATD and services delivered in the EIP. C. Vendor shall maintain accurate and complete records that support claiming for actual ATD and services delivered and/or rendered. D. Vendor understands and hereby agrees that the Vendor shall not claim for payment prior to the ATD or service is delivered. E. Vendor shall use uniform and consistent procedures as directed by the Department’s fiscal agent for submission of claims. F. Vendor understands that, for children who have coverage under an insurance policy, plan or health benefit package, including the Medicaid Assistance Program or other governmental payor, payment from such insurer or health plan shall be sought prior to payment from the Municipality being issued, in accordance with PHL §2559. Vendor shall not delay delivery of the AT device or AT service pending payment. Delivery of the device or provision of the AT service shall occur in accordance with the timeframes set forth in paragraph E of Article II. G. Vendor shall utilize the fiscal agent in seeking payment from such insurer or health plan. Vendor shall further take the appropriate steps to secure insurer or health plan payment for services, including responding to claim denials by correcting any errors identified in claims, providing requested documentation such as that needed to support medical necessity, and the submission of Subrogation notice to each child's insurance company. H. Vendor shall promptly notify the Department’s state fiscal agent of any duplicate or erroneous payment received from any third party, State or Municipal payor and cooperate with the Department and/or its state fiscal agent to rectify the situation. I. Vendor shall make available and accessible to the Department and Municipality, all records and information necessary to assure the appropriateness of payments made to the Vendor and to assure the Vendor’s compliance with all applicable statutes and regulations, and shall cooperate with all monitoring and audits of Vendor in relation to ATD and services delivered in the EIP.