Retroactive denial definition

Retroactive denial means the practice of denying previously paid claims by
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Retroactive denial means the practice of denying previously paid claims by withholding or setting off against payments, or in any other manner reducing or affecting the future claim payments to the provider, or to seek direct cash reimbursement from a provider for a payment previously made to the provider.
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Retroactive denial means the practice of denying
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Examples of Retroactive denial in a sentence

  • Retroactive denial of a previously paid claim" or "retroactive denial of payment" means any attempt by a carrier retroactively to collect payments already made to a claimant with respect to a claim, or any portion thereof, by requiring repayment of such payments, by reducing other payments currently owed to the claimant, by withholding or setting off against future payments, or in any other manner reducing or affecting the future claim payments to the claimant.

  • Retroactive denial of a previously paid claim" or "retroactive denial of payment" means any attempt by a carrier retroactively to collect payments already made to a claimant with respect to a claim, or any portion thereof, by requiring repayment of such payments, by reducing other payments owed to the claimant, by withholding or setting off against future payments, or in any other manner reducing or affecting the future claim payments to the claimant.

  • Recoupment from future provider payments; * * * (H) Attendance at provider education sessions; * * * (J) One hundred percent (100%) review of the provider's claims prior to payment[.] * * * (M) Retroactive denial of payments; * * * (5) Amounts Due the Department of Social Services From a Provider.

  • Retroactive denial of a previously paid claim or retroactive denial of payment means any attempt by Delta Dental of Virginia retroactively to collect payments already made to you with respect to a claim by reducing other payments currently owed to you, by withholding or setting off against future payments, or in any other manner reducing or affecting the future claim payments to you.

  • Retroactive denial of the exemption, and collection of sales taxes formerly exempted under the owner builder certificate.

  • Retroactive denial of a previously paid claim or retroactive denial of payment means any attempt by DDVA retroactively to collect payments already made to you with respect to a claim by reducing other payments currently owed to you, by withholding or setting off against future payments, or in any other manner reducing or affecting the future claim payments to you.

  • The Chairman and the Rapporteur of the General Assembly shall sign the minutes.

  • DERWARTDeputy Commissioner Bulletin 22-08 Date: June 28, 2022 To: All Life & Health Insurers; Nonprofit Health Service Plans; Health Maintenance Organizations and Managed Care Organizations Re: Section 15-1008(c)(ii): Retroactive denial of health claims The purpose of this Bulletin is to remind carriers of their obligation to promptly acknowledge responsibility for a covered health service when requested to do so by another carrier seeking to coordinate benefits under Md. Ann.

Related to Retroactive denial

  • Benefit year means the period of twelve consecutive months, July 1 through June 30, as established by an employer in which an employee shall accrue and use earned sick leave as provided pursuant to N.J.S.A. 34:11D-2, provided that once the starting date of the benefit year is established by the employer it shall not be changed unless the employer notifies the Commissioner of Labor and Workforce Development of the change in accordance with regulations promulgated pursuant to the Act. The Commissioner shall impose a benefit year on any employer the Commissioner determines is changing the benefit year at times or in ways that prevent the accrual or use of earned sick leave by an employee.

  • Excess Compensation means Compensation in excess of the following Integration Level: (Choose (1) or (2))

  • Net direct written premiums means direct gross premiums written in this state on insurance policies subject to this chapter, less return premiums and dividends paid or credited to policyholders on such direct business. “Net direct written premiums” does not include premiums on a contract between insurers or reinsurers.

  • Base Year means the period set forth in Section 5 of the Summary.

  • License year means the period of time for which a

  • Covered Compensation means any Incentive-Based Compensation granted, vested or paid to a person who served as an Executive Officer at any time during the performance period for the Incentive-Based Compensation and that was Received (i) on or after the effective date of the NYSE listing standard, (ii) after the person became an Executive Officer and (iii) at a time that the Company had a class of securities listed on a national securities exchange or a national securities association.

  • Matching Period has the meaning specified in Section 5.4(1)(e).