Provider Claims Disputes Sample Clauses

Provider Claims Disputes a. The Contractor shall assist ADHS in processing Provider Claims Disputes by ensuring its staff and contracted provider’s staff comply with procedural requirements described in the ADHS/DBHS Provider Manual and the ADHS/DBHS Policies and Procedures Manual, including, but not limited to, providing requested information and documents and participating in administrative hearings, as necessary. To the extent a decision made in response to a Provider Claims Dispute identifies the Contractor as financially responsible, ADHS shall work collaboratively with the Contractor to reach consensus prior to the written decision being issued.
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Provider Claims Disputes. 1.2.5. Provider shall assist members in understanding their right to file grievances and appeals in conformance with the ADHS/DBHS Provider Manual, 5.1, Notice Requirements and Appeal Process for Title XIX and Title XXI Eligible Persons, and to implement ADHS/DBHS, AHCCCS, or Company decisions issued to resolve a complaint, SMI grievance, or member appeals.
Provider Claims Disputes. 1.2.5. Provider shall assist members in understanding their right to file grievances and appeals in conformance with the Mercy Maricopa Provider Manual, 5.1 and all ADHS grievance system and member rights policies. Provider shall implement ADHS/DBHS, AHCCCS, or Company decisions issued to resolve a member or SMI grievance, or member appeals.

Related to Provider Claims Disputes

  • Policy Disputes Any dispute concerning the interpretation of the terms, conditions, limitations and/or exclusions contained herein is understood and agreed by both You and Us to be adjudicated or interpreted in accordance with Indian law and only competent Courts of India shall have the exclusive jurisdiction to try all or any matters arising hereunder. The matter shall be determined or adjudicated in accordance with the law and practice of such Court.

  • Claims and Disputes A. Claims by CONTRACTOR shall be made in writing to the COUNTY within two (2) business days after the commencement of the event giving rise to such claim or CONTRACTOR shall be deemed to have waived the claim. All claims shall be priced in accordance with the section in this document entitled “Changes in Work”.

  • Labor Disputes No labor disturbance by or dispute with employees of the Company or any of its Subsidiaries exists or, to the knowledge of the Company, is threatened which would reasonably be expected to result in a Material Adverse Effect.

  • Contract Disputes The Parties shall deal in good faith and attempt to resolve potential disputes informally. If the dispute concerning a question of fact arising under the terms of this Contract is not disposed of in a reasonable period of time by the Contractor’s Supervisor and the County‘s project manager as specified in Article 25. Notices by way of the following process, such matter shall be brought to the attention of the County DPA by way of the following process:

  • Claims Subject to Mandatory Arbitration The following claims, if not settled through informal Dispute Resolution, will be subject to mandatory arbitration pursuant to Section 10.7 below:

  • Fee Disputes If You in good faith dispute the amount of any invoice, You will timely pay the undisputed amount and will notify Us in writing of the disputed amount no later than the date payment would otherwise be due, providing the reasons for the dispute. The parties will attempt in good faith to resolve the dispute within thirty (30) days after Our receipt of Your notice of dispute (the “Resolution Period”), during which time withholding of the disputed amount will not be considered a material breach of this Agreement, no interest will accrue for late payment of the disputed amount. Upon resolution of the dispute, You will pay the resolved amount promptly but in any case within ten (10) days of mutual written agreement resolving the dispute. If the dispute is not resolved within the thirty-day (30) Resolution Period, then each party will be entitled to pursue all available remedies.

  • Payment Disputes We will not exercise Our rights under Section 6.3 (Overdue Charges) or 6.4 (Suspension of Service and Acceleration) above if You are disputing the applicable charges reasonably and in good faith and are cooperating diligently to resolve the dispute.

  • All Claims Must be Arbitrated It is the intention of the parties that this agreement bind all parties whose claims may arise out of or relate to treatment or service provided by the physician including any spouse or heirs of the patient and any children, whether born or unborn at the time of the occurrence giving rise to any claim. In the case of any pregnant mother, the term “patient” herein shall mean both the mother and the mother’s expected child or children. All claims for monetary damages exceeding the jurisdictional limit of the small court against the physician, and physician’s partners, associates, association, corporation partnership, and the employees, agents, and estates of any of them, must be arbitrated including, without limitation, claims for loss of consortium, wrongful death, emotional distress, or punitive damages. Filing any action in any court by the physician to collect any fee from the patient shall not waive the right to compel arbitration of any malpractice claim.

  • Disputes and Claims Failure to file such a protest within the time specified shall constitute agreement on the part of the Contractor with the terms, conditions, amounts and adjustments or non- adjustment to the contract price and/or contract time set forth in the field order.

  • Billing Disputes 7.6.3.1 Each Party agrees to notify the other Party upon the discovery of a billing dispute. In the event of a billing dispute, the Parties will endeavor to resolve the dispute within sixty (60) calendar days of the Xxxx Date on which such disputed charges appear. Resolution of the dispute is expected to occur at the first level of management resulting in a recommendation for settlement of the dispute and closure of a specific billing period. If the issues are not resolved within the allotted time frame, the following resolution procedure will begin:

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