Retroactive Eligibility Adjustments. You agree to accept and abide by retroactive adjustments made by us to our State Health Plan Member eligibility records and associated adjustments to your reimbursement. We agree to use best efforts to make retroactive adjustments within ninety (90) days after the date the claim was processed. You agree that if Medically Necessary Covered Services were provided to a State Health Plan Member during any retroactive adjustment period for which that State Health Plan Member is added as an eligible State Health Plan Member, you will reimburse the State Health Plan Member for any payments made by the State Health Plan Member for such services and/or supplies within forty-five (45) days of receiving the retroactive adjustment, except for any applicable Deductibles, Coinsurance, and/or Copayments. Further, you agree to reimburse any payments made by us for any services provided to ineligible members within forty-five (45) days of receiving the retroactive adjustment.
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Samples: Participation Agreement, North Carolina State Health Plan Network Participation Agreement, Participation Agreement
