Common use of Error in Payment Clause in Contracts

Error in Payment. HCT may, at its sole option, recover payment or retain portions of future payments in the event that HCT determines that an individual was not an eligible Member at the time of services, or in the event of duplicate payment, Improper Payment, payment for non-Covered Services, or fraud. In the event Group receives an Improper Payment, Group shall promptly notify HCT of the Improper Payment in writing. Upon notice or identification of an Improper Payment, HCT shall have the ability to recoup or immediately recover the Improper Payment amount from the Group. If HCT conducts its own audit and discovers an Improper Payment, HCT will notify Group immediately. If Group disagrees with a determination of an Improper Payment, Group must submit, within thirty (30) days after receipt of notification, a written explanation along with all supporting documents. If Group does not provide explanation, HCT has the right to recoup all Improper Payment. If HCT disagrees with Group’s written explanation, Group will have the right to appeal as indicated in HCT’s appeal procedures.