Third-Party Payer Clause Samples
A Third-Party Payer clause defines the involvement of an external entity, separate from the primary contracting parties, that is responsible for making payments under the agreement. Typically, this clause specifies the identity of the third-party payer, the scope of their payment obligations, and the procedures for invoicing and remittance. For example, in a healthcare or insurance context, a third-party payer might be an insurance company that pays service providers on behalf of the insured. The core function of this clause is to clarify payment responsibilities and ensure that all parties understand who is financially liable, thereby reducing confusion and potential disputes over payment.
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Third-Party Payer. If Customer desires to use a third-party to pay some or all of the Fees on behalf of Customer (a “Third-Party Payer”), then (i) each applicable Addendum will identify such arrangement, (ii) the Third- Party Payer will enter into a written agreement with ESO regarding such arrangement, (iii) Customer may replace the Third-Party Payer by written notice to ESO (provided that no such change shall be made until the then-current Term’s renewal), (iv) references within this Section 5 to Customer’s responsibility for Fees shall be understood to refer to the Third-Party Payer when applicable, and (v) Customer shall remain responsible for payment if the Third-Party Payer does not pay the Fees.
Third-Party Payer. Where a third party is the designated party for payment of fees under the Agreement, You agree You shall be solely responsible for ensuring payment of all fees owed to CGM by the Third Party Payer. You agree that if Third Party Payer, its representatives, heirs, and assigns fail to make any payment of fees owed to CGM in accordance to the terms of this Agreement, You shall assume the responsibility and make immediate payment of said fees to CGM. You shall be reimbursed by CGM for any fees paid on behalf of Third Party Payer when payment of all fees owed is received and paid in full by Third Party Payer.
Third-Party Payer. The Contractor will not seek reimbursement from any federal healthcare program or third party payer for any amounts paid by University that are being reimbursed as study related services.
Third-Party Payer. Third-Party Payer shall pay all Fees on behalf of Customer, provided: (i) each applicable Addendum will identify such arrangement, (ii) the Third-Party Payer will enter into a written agreement with ESO regarding such arrangement, and (iii) Customer may replace the Third-Party Payer by written notice to ESO (provided that no such change shall be made until the then-current Term’s renewal).
Third-Party Payer. This section only applies to Participants whose cost of participation in the Program will be reimbursed by a third party payer, such as a health plan or insurance company (such entity a “Payer”).
i. Applicable laws, rules, and regulations may permit AbleTo to release diagnostic, procedure, billing, attendance and other health-related information to a Payer, and Participant acknowledges and agrees that AbleTo may release such information to a Payer in accordance with the Notice of Privacy Practices.
ii. Payers may make payment(s) on Participant’s behalf to AbleTo for any Program services provided by AbleTo. These payments do not, however, alleviate the Participant from any required cost sharing payments required by the Program and/or the Payer, nor does it alleviate the obligation of the Participant to reimburse AbleTo for services provided should the Payer fail to do so.
iii. The Participant is responsible to notify AbleTo of any changes to applicable Payers, so that AbleTo may assess the impact of those changes in coverage. In the event that Payer terminates its coverage of a Participant and/or no longer reimburses AbleTo for services provided, Program sessions will end, and AbleTo will transition the Participant’s care in accordance with relevant laws, rules, and regulations and assist the Participant in developing an interim plan (for example, with a clinic that provides behavioral health services on a sliding scale, or instructions on when to use emergency services) until ▇▇▇▇▇▇ receives reimbursement on behalf of the Participant or the Participant transitions his or her care.
Third-Party Payer. SAS acknowledges that Dell/ASAP Software will pay license fees and act as order administrator on Customer’s behalf. Customer shall be responsible for any related charges assessed by such third party. When a third party is designated by Customer to pay fees and administer orders under the Agreement, SAS (or its designee) will send invoices and its standard notices regarding fees only to such third party, and all payments due under the Agreement will remain Customer’s ultimate responsibility. SAS is not required to provide the product authorization code that enables the Software to operate or notices of nonpayment to Customer if license fees are not paid and shall not be liable for any damages resulting from the resulting Software interruption. Authorization for a third party to administer orders and pay license fees creates no other relationship between SAS and the third party. The third party is not authorized to access the Software or to act on Customer's behalf with respect to the Agreement or its administration, other than to issue orders and pay fees.
Third-Party Payer. If Customer desires to use a third-party entity, including, without Limitation, Digitech Computer, LLC, to pay some or al1 of the Fees on behalf of Customer (a"Third-Party Payer"), then (i) CUSTOMER shall notify EPR in writing of the designated Third Party Payer and the terms of the arrangement, (ii) the Third-Party Payer will enter into a written agreement with EPR regarding such arrangement, (iii) Customer may replace the Third-Party Payer by written notice to EPR (provided that no such change shall be made until the then-current Term's renewal), (iv) references within this Section 8 to Customer's responsibility for Fees shall be understood to refer to the Third-Party Payer when applicable, and (v) Customer shall remain responsible for payment if the Third-Party Payer does not pay the Fees.
Third-Party Payer. Institution shall not submit or cause to be submitted any request for reimbursement to a Study subject, federal or state health care program or third party payer for services, products or expenses that are paid for or provided in connection with this Agreement.