Billing Form definition

Billing Form means the document generated by the Department that acts as a prior authorization, contract, and payment mechanism for services.
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Billing Form means the document generated by the Seniors and People with Disabilities Division that acts as a prior authorization, contract, and payment mechanism for services.
Sample 1Sample 2Sample 3

Examples of Billing Form in a sentence

  • The Parties agree that billing requirements and outputs will be consistent with the Ordering & Billing Form (OBF) and also with Telcordia Technologies Billing Output Specifications (BOS).

  • An Explanation of Benefits from the insurance company shall be submitted with the claim to the CBO.Submit legible claims to the CBO on the CMS 1500 form, UB04 form, and for transportation on the CBO Billing Form, or an exact electronic facsimile of one of these forms.

  • Once adopted, hospital providers shall sub- mit outpatient hospital bills on the current version of the Universal Billing Form (UB) and use HCPCS codes and other coding schemes in accordance with the OWCP OPPS.

  • Every reasonable effort has been made to ensure the accuracy of the information obtained from the Uniform Claims and Billing Form (UB-82/92/04) data elements.

  • From the patients Master Record, click on Create Invoice .Note: Example Billing Form below.

  • Reserve field utilization and addition or deletion of data elements.--The council shall include in the Pennsylvania Uniform Claims and Billing Form a reserve field.

  • Costs claimed on the Development Project Billing Form must be reviewed and attested to by an independent CPA in accordance with the Statement on Standards for Attestation Engagements as established by the American Institute of Certified Public Accountants.

  • Establish a Pennsylvania Uniform Claims and Billing Form for all data sources and all providers which shall be utilized and maintained by all data sources and all providers for all services covered under this act.

  • Responsibilities Of The Financial ClerkThe Financial Clerk will receive the DFA-67-A, Burial Billing Form, from the Funeral Home Director.

  • The council shall include in the Pennsylvania Uniform Claims and Billing Form a field consisting of the data elements required pursuant to subsection (c)(21) to provide information on each provision of covered services sufficient to permit analysis of provider quality and provider service effectiveness within 180 days of commencement of its operations pursuant to section 4.

Related to Billing Form

  • Billing involves the provision of appropriate usage data by one Telecommunications Carrier to another to facilitate Customer Billing with attendant acknowledgments and status reports. It also involves the exchange of information between Telecommunications Carriers to process claims and adjustments.

  • Booking Form means the booking form you completed setting out details of your order in respect of the Event;

  • Invoice means a Contractor’s claim for payment. At the Agency’s discretion, claims may be submitted on an original invoice from the Contractor or may be submitted on a claim form acceptable to the Agency, such as a General Accounting Expenditure (GAX) form.

  • Local Service Ordering Guide or "LSOG" is a document developed by the OBF to establish industry-wide ordering and Billing processes for ordering local services.

  • Billing Statement means the billing statement for your Account.

  • Calling Name Delivery Service (CNDS means a service that enables a terminating End User to identify the calling Party by a displayed name before a call is answered. The calling Party’s name is retrieved from a calling name database and delivered to the End User’s premise between the first and second ring for display on compatible End User premises equipment.

  • Purchase Order means the form or format a Customer uses to make a purchase under the Contract (e.g., a formal written purchase order, electronic purchase order, procurement card, contract or other authorized means).

  • Billing System means a system to issue Invoices relating to charges payable by each party under an Access Agreement;

  • Freight forwarding services means the activity consisting of organising and monitoring shipment operations on behalf of shippers, through the acquisition of transport and related services, preparation of documentation and provision of business information.

  • Rolling Forecast has the meaning set forth in Section 4.2.

  • Shipment means a volume of products offered to and accepted by Carrier for transportation.

  • Cloud Service Order Form means all written order forms or other ordering documentation for Cloud Services entered into by SAP, or a SAP SE Affiliate or a reseller of SAP SE or an SAP SE Affiliate, and Prime Contractor.

  • Prepaid wireless calling service means a telecommunications service that provides the right to utilize mobile wireless service as well as other non-telecommunications services, including the download of digital products delivered electronically, content and ancillary services, which must be paid for in advance that is sold in predetermined units or dollars of which the number declines with use in a known amount.

  • Software Order Form means the order form for the Software, Third Party Software and related SAP Support ordered by Licensee thereunder, including information on Software, Third Party Software, SAP Support, fees, and other information necessary for the delivery of such items to Licensee.

  • Detailed telecommunications billing service means an ancillary service of separately stating information pertaining to individual calls on a customer's billing statement.

  • The Purchase Order means the order placed by the Purchaser on the Supplier signed by the Purchaser including all attachments and appendices thereto and all documents incorporated by reference therein. The purchase order shall be deemed as "Contract" appearing in the document.

  • Firm Order has the meaning set forth in Section 3.2.

  • Delivery Services means those services provided by the

  • Service Order Form means our standard Service Order Form for Services, or any other order form that we agree with you in writing that incorporates the provisions of this DPA;

  • Long Form Notice means the form of notice that shall be posted on the Settlement Website created by the Settlement Administrator and shall be available to Settlement Class members by mail on request made to the Settlement Administrator in the form attached as Exhibit 2.

  • Account Opening Form means standardized form prescribed by the management Company to be duly filled by the investors at the time of opening an account with the Fund.

  • Case Report Form means a printed, optical or electronic document or database designed to record all of the information, which is required by the Protocol to be reported to the Sponsor on each Study Participant.

  • Delivery service means the providing of electric transmission or distribution to a retail customer.

  • Contract Services means the Services to be supplied by the Supplier to the Customer as set out in the Letter of Appointment;

  • Customer Service Agreement shall have the meaning as defined in the Master Agreement. “ Customer User” means an employee of Customer, a Customer Affiliate or Business Partner.

  • Delivery Schedule means the schedule for the delivery of Services as set forth in attached Annex 3.