Financial Subsystem. The financial function encompasses claim payment processing, adjustment processing, accounts receivable processing, and all other financial transaction processing. This function ensures that all funds are appropriately disbursed for claim payments and all post-payment transactions are applied accurately. The financial processing function is the last step in claims processing and produces remittance advice statements/explanation of benefits and financial reports. The Contractor’s financial subsystem shall contain such items as: update of provider payment data, tracking of financial transactions, including TPL recoveries and maintenance of adjustment and recoupment processes.
Appears in 4 contracts
Sources: Medicaid Managed Care Contract, Medicaid Managed Care Contract, Medicaid Managed Care Contract
Financial Subsystem. The financial Financial subsystem function encompasses claim Claim payment processing, adjustment processing, accounts receivable processing, and all other financial transaction processing. This function subsystem ensures that all funds are appropriately disbursed for claim Claim payments and all post-payment transactions are applied accurately. The financial processing function is the last step in claims Claims processing and produces remittance advice statements/explanation of benefits and financial reports. The Contractor’s financial subsystem shall contain such items as: update of provider payment data, tracking of financial transactions, including TPL recoveries and maintenance of adjustment and recoupment processes.
Appears in 1 contract
Sources: Managed Care Contract (Wellcare Health Plans, Inc.)
Financial Subsystem. The financial Financial subsystem function encompasses claim Claim payment processing, adjustment processing, accounts receivable processing, and all other financial transaction processing. This function subsystem ensures that all funds are appropriately disbursed for claim Claim payments and all post-post- payment transactions are applied accurately. The financial processing function is the last step in claims Claims processing and produces remittance advice statements/explanation of benefits and financial reports. The Contractor’s financial subsystem shall contain such items as: update of provider payment data, tracking of financial transactions, including TPL recoveries and maintenance of adjustment and recoupment processes.
Appears in 1 contract
Sources: Medicaid Managed Care Contract