Common use of Timely Payment Requirement Clause in Contracts

Timely Payment Requirement. The MCO must agree to make timely claims payments to both its contracted and non-contracted providers. A claim is defined as a bill for services, a line item of service, or all services for one recipient within a bill. A clean claim is defined as one that can be processed without obtaining additional information from the provider of the service or from a third party. It does not include a claim from a provider who is under investigation for fraud or abuse, or a claim under review for medical necessity. The MCO must pay all clean in-network provider claims for covered services within thirty (30) calendar days of receipt, except to the extent the provider has agreed to later payment in writing. The MCO must pay all electronic out-of-network clean claims within thirty (30) days and all paper out-of-network clean claims within forty (40) days from the date of receipt, except to the extent the provider has agreed to later payment in writing. The MCO must agree to specify the date of receipt as the date the MCO receives the claim, as indicated by its date stamp (including electronic date stamp) on the claim, and date of payment as the date of the check release or other form of payment release to the provider. The MCO must pay in-network providers interest at seven (7) percent per annum, calculated daily for the full period in which the clean claim remains unpaid beyond the thirty (30) day clean claims payment deadline. Interest owed to the provider must be paid on the same date as the claim. The interest paid to the providers will not be reported as a part of the MCO encounter data. This provision does not apply to payments made due to a rate change per Article III, §2.7.9.

Timely Payment Requirement. The MCO must agree to make timely claims payments to both its contracted and non-contracted providers. A claim is defined as a bill for services, a line item of service, or all services for one recipient within a bill. A clean claim is defined as one that can be processed without obtaining additional information from the provider of the service or from a third party. It does not include a claim from a provider who is under investigation for fraud or abuse, or a claim under review for medical necessity. The MCO must pay all clean in-network provider claims for covered services within thirty (30) 30 calendar days of receipt, except to the extent the provider has agreed to later payment in writing. The MCO must pay all electronic out-of-network clean claims within thirty (30) 30 days and all paper out-out- of-network clean claims within forty (40) 40 days from the date of receipt, except to the extent the provider has agreed to later payment in writing. The MCO must agree to specify the date of receipt as the date the MCO receives the claim, as indicated by its date stamp (including electronic date stamp) on the claim, and date of payment as the date of the check release or other form of payment release to the provider. The MCO must pay in-network providers interest at seven (7) percent % per annum, calculated daily for the full period in which the clean claim remains unpaid beyond the thirty (30) -day clean claims payment deadline. Interest owed to the provider must be paid on the same date as the claim. The interest paid to the providers will not be reported as a part of the MCO encounter data. This provision does not apply to payments made due to a rate change per Article III, §2.7.9.

Timely Payment Requirement. The MCO must agree to make timely claims payments to both its contracted and non-contracted providers. A claim is defined as a bill xxxx for services, a line item of service, or all services for one recipient within a billxxxx. A clean claim is defined as one that can be processed without obtaining additional information from the provider of the service or from a third party. It does not include a claim from a provider who is under investigation for fraud or abuse, or a claim under review for medical necessity. The MCO must pay all clean in-network provider claims for covered services within thirty (30) 30 calendar days of receipt, except to the extent the provider has agreed to later payment in writing. The MCO must pay all electronic out-of-network clean claims within thirty (30) 30 days and all paper out-out- of-network clean claims within forty (40) 40 days from the date of receipt, except to the extent the provider has agreed to later payment in writing. The MCO must agree to specify the date of receipt as the date the MCO receives the claim, as indicated by its date stamp (including electronic date stamp) on the claim, and date of payment as the date of the check release or other form of payment release to the provider. The MCO must pay in-network providers interest at seven (7) percent % per annum, calculated daily for the full period in which the clean claim remains unpaid beyond the thirty (30) -day clean claims payment deadline. Interest owed to the provider must be paid on the same date as the claim. The interest paid to the providers will not be reported as a part of the MCO encounter data. This provision does not apply to payments made due to a rate change per Article III, §2.7.9.

Timely Payment Requirement. The MCO must agree to make timely claims payments to both its contracted and non-contracted providers. A claim is defined as a bill for services, a line item of service, or all services for one recipient within a bill. A clean claim is defined as one that can be processed without obtaining additional information from the provider of the service or from a third party. It does not include a claim from a provider who is under investigation for fraud or abuse, or a claim under review for medical necessity. The MCO must pay all clean in-network provider electronic and paper claims for covered services from both in- network and out-of-network providers within thirty (30) calendar days of receipt, except to the extent the provider has agreed to later payment in writing. The MCO must pay all electronic out-of-network clean claims within thirty (30) days and all paper out-of-network clean claims within forty (40) days from the date of receipt, except to the extent the provider has agreed to later payment in writing. The MCO must agree to specify the date of receipt as the date the MCO receives the claim, as indicated by its date stamp (including electronic date stamp) on the claim, and date of payment as the date of the check release or other form of payment release to the provider. The MCO shall report quarterly on all overdue clean claims for both in-network and out-of- network providers as noted in Appendix E. The MCO must pay in-network providers interest at seven (7) percent per annum, calculated daily for the full period in which the clean claim remains unpaid beyond the thirty (30) calendar day clean claims payment deadline. Interest owed to the provider must be paid on the same date as the claim. The interest paid to the providers will not be reported as a part of the MCO encounter data. This provision does not apply to payments made due to a rate change per Article III, §Section 2.7.9.