Examples of POS System in a sentence
The POS System transaction response pricing per Claim prevails, unless overpayment is made to the Network Pharmacy Provider.
Network Pharmacy Providers may not charge the Member more than the Cost-Sharing Amount provided by the POS System, including for non-covered ingredients.
In the event that Network Pharmacy Provider has submitted a Claim via the POS System and Network Pharmacy Provider does not receive any Claim response Transaction message via the POS System within a reasonable amount of time, Network Pharmacy Provider should verify the accuracy of the submitted Claim and resubmit the Claim to Administrator via the POS System.
However, excessive or disruptive process inquiries, including, but not limited to non-contracted pharmacy status, duplicate payment and remittance requests, excessive Member/Network Pharmacy Provider grievances, third-party biller intervention, incomplete or inaccurate credentialing submissions, contract non-compliance and/or failure of the Network Pharmacy Provider to submit Claims through the Administrator designated claim processor POS System, are subject to higher transmission fees.
For claims submitted for Medicare Part B Covered Prescription Services for the respective Benefit Plan Sponsor’s MA or MA-PD Benefit Plans, Network Pharmacy Provider shall refer to the POS System response for the applicable Benefit Plan as payment in full.