For Pharmacy Claims. 1. The Health Plan shall within fourteen (14) calendar days of receiving a pharmacy claim pay or deny a clean pharmacy claim or notify the provider that more information is needed to process the claim. 2. A pharmacy pended claim shall be paid or denied within fourteen (14) calendar days of receipt of the requested additional information.
Appears in 3 contracts
Sources: Participating Provider Agreement, Participating Provider Agreement, Participating Provider Agreement
For Pharmacy Claims. 1. The Health Plan shall within fourteen (14) calendar days of receiving a pharmacy claim pay or deny a clean pharmacy claim or notify the provider that more information is needed to process the claim.
2. A pharmacy pended claim shall be paid or denied within fourteen (14) calendar days of receipt of the requested additional information.
Appears in 1 contract
Sources: Health Services Agreement