Payment for Inaccurately Paid Claims Sample Clauses

Payment for Inaccurately Paid Claims. Within a reasonable time after execution of this Agreement, UPMC and Evolent shall mutually agree upon claims quality control procedures that shall be included in a Claims Procedures Manual. Until the Parties reach such mutual agreement, the UPMC claims quality control procedures in effect as of the Effective Date shall govern for purposes of this Section. With respect to claims processed by UPMC on or after the Effective Date in a manner that does not materially comply with the then-applicable claims quality control procedures and occurred as a result of UPMC’s intentional misconduct or negligent acts or omissions, UPMC shall pay the cost of inaccurate payments to nonparticipating Providers (or participating Providers where the right of offset will not provide Evolent a recovery within a six (6) month time period; provided, however, that for purposes of this Section, Evolent shall be presumed to have a right of offset against any participating Provider, regardless of whether the contract between Evolent and the Provider grants Evolent any such right), if (i) the payment was made in error, (ii) the erroneous payment was not the result of an error of party other than UPMC, (iii) the payment resulted in more than (a) $10,000 in excess payments to a Provider for a single course of treatment, or (b) $25,000 in total excess payments resulting from a pattern, practice or methodology producing multiple erroneous payment. In consideration of such payments by UPMC, Evolent shall assign to UPMC any claim it may have against the Provider to recover any such erroneous payment. With respect to claims processed by UPMC in a manner that complies with the then-applicable claims quality control procedures, UPMC shall have no repayment obligation under this Section.
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Related to Payment for Inaccurately Paid Claims

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  • Purchase for Own Account for Investment Purchaser is purchasing the Shares for Purchaser’s own account for investment purposes only and not with a view to, or for sale in connection with, a distribution of the Shares within the meaning of the Securities Act. Purchaser has no present intention of selling or otherwise disposing of all or any portion of the Shares and no one other than Purchaser has any beneficial ownership of any of the Shares.

  • DETERMINATION OF MATTERS NOT PROVIDED FOR IN THIS AGREEMENT The Managers shall decide any questions arising with respect to the Company and this Agreement which are not specifically or expressly provided for in this Agreement.

  • Payment for Improvements If payment is made directly to contractors, Tenant shall (i) comply with Landlord's requirements for final lien releases and waivers in connection with Tenant's payment for work to contractors, and (ii) sign Landlord's standard contractor's rules and regulations. If Tenant orders any work directly from Landlord, Tenant shall pay to Landlord an amount equal to five percent of the cost of such work to compensate Landlord for all overhead, general conditions, fees and other costs and expenses arising from Landlord's involvement with such work. If Tenant does not order any work directly from Landlord, Tenant shall reimburse Landlord for Landlord's reasonable, actual, out-of-pocket costs and expenses actually incurred in connection with Landlord's review of such work.

  • No Liability for Investments None of the Depositor, the Servicer, the Indenture Trustee or the Qualified Institution maintaining any Bank Account will be liable for the selection of Permitted Investments or for investment losses incurred on Permitted Investments (other than in the capacity as obligor, if applicable).

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  • No Liability for Interest Unless otherwise agreed with the Company, the Warrant Agent shall have no liability for interest on any monies at any time received by it pursuant to any of the provisions of this Agreement or of the Warrant Certificates.

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