Third Party Resource definition
Examples of Third Party Resource in a sentence
The LDSS shall use its best efforts to maintain third party information on the WMS/MMIS Third Party Resource System.
The LDSS is also responsible for making diligent efforts to determine if Enrollees have TPHI and to maintain third party information on the WMS/eMedNY Third Party Resource System.
When engaging in Third Party Resource recovery actions, Subcontractor shall comply with federal and State confidentiality requirements, described in Exhibit B of the CCO Contract.
For clarification, such Required Consents will be obtained so as to enable ACS to provide the Services (i) upon the Service Commencement Date, and (ii) following the Service Commencement Date to the extent the parties agree that ACS will continue to use a Customer Third Party Resource to provide the Services.
A Claim for which Fraud is suspected; and iii A Claim for which a Third Party Resource should be responsible.
Funding will be reduced (offset) by the amount of funding received by the Service Provider from the Individual, the Individual’s health insurance provider, another person’s health insurance provider under which Individual is also covered, or any other Third Party Resource (TPR) in support of Individual’s care and Services provided.
If the Contractor does not become aware of another Third Party Resource until after the payment for service, the Contractor is responsible to seek recovery from the Third Party Resource or the provider on a post-payment basis.
None of StrategIQ, nor any of its officers (direct or indirect), managers, employees, service providers, agents or affiliates, have control over any aspect of the Third Party Resources, any modification, suspension, or termination of Third Party Resources, or the use of any information shared with any Third Party Resource.
If a Third Party Resource has reimbursed Provider, or if a Member, after receiving payment from a Third Party Resource, has reimbursed Provider, Provider shall reimburse Medicare up to the full amount the Provider received, if Medicare is unable to recover its payment from the remainder of the Third Party Resource payment.
The LDSS shall use its best efforts to maintain third party information, on the WMSIMMIS Third Party Resource System.