Review Prerequisites. Upon the request of a Debtor, the Creditor Agency has provided for a review of the Debtor’s claim(s), including an opportunity for reconsideration of the initial decision on the Debt.
Review Prerequisites Sample Clauses
Related to Review Prerequisites
Review Protocol A narrative description of how the Claims Review was conducted and what was evaluated.
Review Procedure If the Plan Administrator denies part or all of the claim, the claimant shall have the opportunity for a full and fair review by the Plan Administrator of the denial, as follows:
Claims Review Population A description of the Population subject to the Claims Review.
Review Process A/E's Work Product will be reviewed by County under its applicable technical requirements and procedures, as follows:
Maintenance of Review Materials It will maintain copies of any Review Materials, Review Reports and other documents relating to a Review, including internal correspondence and work papers, for a period of at least two years after any termination of this Agreement.
Claims and Review Procedure 5.1 For all claims other than disability benefits:
Access to Review Materials The Servicer will give the Asset Representations Reviewer access to the Review Materials for all of the Subject Receivables within sixty (60) calendar days after receipt of the review notice in one or more of the following ways in the Servicer’s reasonable discretion: (i) by electronic posting of Review Materials to a password-protected website to which the Asset Representations Reviewer has access, (ii) by providing originals or photocopies of documents relating to the Subject Receivables at one of the properties of the Servicer or (iii) in another manner agreed by the Servicer and the Asset Representations Reviewer. The Servicer may redact or remove PII from the Review Materials so long as all information in the Review Materials necessary for the Asset Representations Reviewer to complete the Asset Review remains intact and unchanged.
Review Procedures The Parties agree to jointly conduct a review, sampling transactions of the incidents managed under this Agreement. Findings that are inconsistent with the normal or accepted way of doing business will be reconciled on a case by case basis. Any decision to further examine records will be considered on a case by case basis and appropriate follow up action agreed upon by all agencies involved.
Training Plan Within 90 days after the Effective Date, Good Shepherd shall develop a written plan (Training Plan) that outlines the steps Good Shepherd will take to ensure that: (a) all Covered Persons receive adequate training regarding Good Shepherd’s CIA requirements and Compliance Program, including the Code of Conduct and (b) all Relevant Covered Persons receive adequate training regarding: (i) the Federal health care program requirements regarding eligibility for hospice services upon initial admission, recertification for continued stay, and for Continuous Care, Respite Care, and General Inpatient Care; (ii) the role of physicians in making eligibility determinations; (iii) the accurate coding and submission of claims; (iv) policies, procedures, and other requirements applicable to the documentation of medical records; (v) the personal obligation of each individual involved in the claims submission process to ensure that such claims are accurate; (vi) applicable reimbursement statutes, regulations, and program requirements and directives; (vii) the legal sanctions for violations of the Federal health care program requirements; and (viii) examples of proper and improper eligibility determinations, documentation, and claims submission practices. The Training Plan shall include information regarding the training topics, the categories of Covered Persons and Relevant Covered Persons required to attend each training session, the length of the training, the schedule for training, and the format of the training. Within 30 days of the OIG’s receipt of Good Shepherd’s Training Plan, OIG will notify Good Shepherd of any comments or objections to the Training Plan. Absent notification by the OIG that the Training Plan is unacceptable, Good Shepherd may implement its Training Plan. Good Shepherd shall furnish training to its Covered Persons and Relevant Covered Persons pursuant to the Training Plan during each Reporting Period.
Claims Submission We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
