Payer of Last Resort. Second Party represents to County that no other reimbursement or payment is available or will be received by Second Party for any services invoiced to County, and County has relied upon that representation. Second Party shall assure that funding under this Agreement will not supplant any existing programs and resources and is used as funding of last resort. This Agreement specifically excludes services eligible to be covered by Medicaid, Medicare, or other third party funding source (collectively referred to as "Third Party Payment"). Second Party shall xxxx and pursue collection of any and all available Third Party Payments and Client payments for services rendered under this Agreement prior to billing County for any such services.
Payer of Last Resort. Provider represents to County that no other reimbursement or payment is available or will be received by Provider for any services invoiced to County, and County has relied upon that representation. Provider must ensure that funding under this Agreement will not supplant any existing programs or resources and is used as funding of last resort. This Agreement specifically excludes i) payments for services eligible to be covered by Medicaid, Medicare, or other third party funding source (“Third Party Funding Source”); ii) any fee collected; iii) non-County reimbursement; or
Payer of Last Resort. SBBC represents to County that no other reimbursement or payment is available or will be received by SBBC for any services invoiced to County, and County has relied upon that representation. SBBC shall assure that funding under this Agreement will not supplant any existing programs and resources and is used as funding of last resort. This Agreement specifically excludes services eligible to be covered by Medicaid, Medicare, or other third party funding source (collectively referred to as "Third Party Payment"). SBBC shall xxxx and pursue collection of any and all available Third Party Payments and Client payments for services rendered under this Agreement prior to billing County for any such services.
Payer of Last Resort. No funds shall be used to provide items or services for which payment has been made or reasonably can be expected to be made, by third party payers, including Medicaid, Medicare, the Early Intervention Program (EIP) and/or State or local entitlement programs, prepaid health plans or private insurance. Therefore, LHJ providing case management services shall expeditiously enroll eligible clients in Medicaid. LHJ will not use funds to pay for any Medicaid-covered services for Medicaid enrollees.
Payer of Last Resort. PROVIDER agrees to comply with the ATR requirement that ATR funds cannot be used by PROVIDER to supplant current funding for existing PROVIDER activities. PROVIDER shall not accept ATR payment if PROVIDER is receiving or could receive any other third-party payment for the service provided to the ATR client by PROVIDER.
Payer of Last Resort. The Board shall be the payer of last resort. The Agency shall bill potential first and third party payers, both public and private, for all Services to Enrolled Clients paid on a Purchase of Service basis under Article 6.3. The Agency shall assure the Board that all clients eligible for Medicaid coverage will apply to Medicaid for coverage unless the client is medically unable to do so. Clients eligible for Medicaid coverage who elect not to apply for Medicaid coverage will not be eligible to receive any subsidized services payable under this non-Medicaid contract.
Payer of Last Resort. 1. The Division of Behavioral Health is the Payer of Last Resort for behavioral health services for consumers who meet:
Payer of Last Resort. Consultant represents to County that no other reimbursement or payment is available or will be received by Consultant for any services invoiced to County, and County has relied upon that representation. [REMOVE THIS PARAGRAPH IF NOT APPLICABLE TO AGREEMENT]
Payer of Last Resort. Subject to the third party liability provisions included in Chapter I of the MBM, reimbursement is contingent upon the Provider billing to the Department only as the payer of last resort. The Providers must take all necessary and reasonable measures within the Provider’s ability to identify, locate and xxxx any and all third-party payers, including Medicare, prior to billing MaineCare pursuant to this Agreement.
Payer of Last Resort. By statute, the Xxxx Xxxxx HIV/AIDS Program (RWHAP) is the “payer of last resort,” meaning that the Xxxx Xxxxx funds may not be used for any item or service for which payment has been made, or “can reasonably be expected to be made,” by any other payer (Sections 2605(a)(6), 2617(b)(7)(F), 2664(f)(1), and 2671(i) of the Public Health Service Act). Every client must be assessed for eligibility for other payers at least every six months, and use effective strategies to coordinate with third-party payers, including Medicaid, that are responsible for covering the cost of services provided to eligible or covered persons. Once an individual is insured, RWHAP funds may be used to pay for any medically necessary services that the insurer does not cover or only partially covers. Partially covered services include services in which the insurer caps the number of services covered in a year or other specified period. RWHAP funds may be used to complete coverage that maintains clients in care when the individual is either underinsured or uninsured for a specific allowable service. In the event a client has exhausted all available services under his/her insurance plan, Xxxx Xxxxx funds may be used to pay for additional necessary services with proof of rejection or ineligibility from the insurer through a prior authorization (PA) process.
