Provider Ownership Disclosure Clause Samples
Provider Ownership Disclosure. Provider agrees to disclose the required information, at the time of application, and/or upon request, in accordance with 42 C.F.R.§ 455 Subpart B, related to ownership and control, business transactions, and criminal conviction for offenses against Medicare, Medicaid, CHIP and/or other federal health care programs. See 42 C.F.R. § 455, Parts 101 through 106 for definitions, percentage calculations, and requirements for disclosure of ownership, business transactions, and information on persons convicted of crimes related to any federal health care programs. Provider agrees to notify, in writing, Health Plan, Subcontractor and the NC Department of Health and Human Services of any criminal conviction within 20 days of the date of the conviction. Additionally, Provider must cooperate with the Department for submission of fingerprints upon a request from the Department or CMS in accordance with 42 CFR 455.434.
Provider Ownership Disclosure. Provider agrees to disclose the required information, at the time of application, and/or upon request, in accordance with 42 C.F.R.§455 Subpart B, related to ownership and control, business transactions, and criminal conviction for offenses against Medicare, Medicaid, CHIP and/or other federal health care programs. See 42 C.F.R. §455, Parts 101 through 106 for definitions, percentage calculations, and requirements for disclosure of ownership, business transactions, and information on persons convicted of crimes related to any federal health care programs. Provider agrees to notify, in writing, Tailored Plan and the NCDHHS of any criminal conviction within twenty (20) days of the date of the conviction. (Section VII. Attachment G.1.3(g) p 85)
Provider Ownership Disclosure. Provider agrees to disclose the required information, at the time of application, and/or upon request, in accordance with 42 C.F.R.§ 455 Subpart B, related to ownership and control, business transactions, and criminal conviction for offenses against Medicare, Medicaid, CHIP and/or other federal health care programs. See
Provider Ownership Disclosure. Participating Provider agrees to disclose the required information, at the time of application, and/or upon request, in accordance with 42 C.F.R.§ 455 Subpart B, related to ownership and control, business transactions, and criminal conviction for offenses against Medicare, Medicaid, CHIP and/or other federal health care programs. See 42 C.F.R. § 455, Parts 101 through 106 for definitions, percentage calculations, and requirements for disclosure of ownership, business transactions, and information on persons convicted of crimes related to any federal health care programs. Participating Provider agrees to notify, in writing, Carolina Complete and the NC DHHS of any criminal conviction within twenty (20) days of the date of the conviction. (Section VII, G(3)(g)).
Provider Ownership Disclosure. PO agrees to disclose the required information, at the time of application, and/or upon request, in accordance with 42 C.F.R.§ 455 Subpart B, related to ownership and control, business transactions, and criminal conviction for offenses against Medicare, Medicaid, CHIP and/or other federal health care programs. See 42 C.F.R. § 455, Parts 101 through 106 for definitions, percentage calculations, and requirements for disclosure of ownership, business transactions, and information on persons convicted of crimes related to any federal health care programs. PO agrees to notify, in writing, Plan and the NC Department of Health and Human Services of any criminal conviction within twenty (20) days of the date of the conviction.
Provider Ownership Disclosure. Provider agrees to disclose the required information, at the time of application, and/or upon request, in accordance with 42 C.F.R.§ 455 Subpart B, related to ownership and control, business transactions, and criminal conviction for offenses against Medicare, Medicaid, CHIP and/or other federal health care programs. See 42 C.F.R. § 455, Parts 101 through 106 for definitions, percentage calculations, and requirements for disclosure of ownership, business transactions, and information on persons convicted of crimes related to any federal health care programs. Provider agrees to notify, in writing, PIHP and NC DHHS of any criminal conviction within twenty (20) days of the date of the conviction. 7.8. Prompt claim payments under health benefit plans. The Provider shall submit all claims to Sandhills Center for processing and payments within one-hundred-eighty (180) calendar days from the date of covered service or discharge (whichever is later). However, the Provider’s failure to submit a claim within this time will not invalidate or reduce any claim if it was not reasonably possible for the Provider to submit the claim within that time. In such case, the claim should be submitted as soon as reasonably possible, and in no event, later than one (1) year from the time submittal of the claim is otherwise required.
7.8.1. Sandhills Center shall within eighteen (18) Calendar Days of receiving a Claim notify the provider whether the claim is clean or pend the claim and request from the provider all additional information needed to process the claim.
7.8.2. Sandhills Center shall pay or deny a Clean Claim at lesser of thirty (30) Calendar Days of receipt of the Claim or the first scheduled provider reimbursement cycle following adjudication.
7.8.3. A medical pended Claim shall be paid or denied within thirty (30) Calendar Days of receipt of the requested additional information.
7.8.4. If the requested additional information on a Claim is not submitted within ninety (90) days of the notice requesting the required additional information, Sandhills Center shall deny the claim.
7.8.5. Sandhills Center shall reprocess claims in a timely and accurate manner as described in this provision (including interest and penalties if applicable).
7.8.6. If Sandhills Center fails to pay a Clean Claim in full pursuant to this provision, Sandhills Center shall pay the Provider interest and penalties. Late Payments will bear interest at the annual rate of eighteen (18) percent beginning...