Claims Information. Provider shall promptly submit to Subcontractor and/or Health Plan (as set forth in the Agreement) the information needed to make payment and shall identify third party liability coverage, including Medicare and other insurance, and, if applicable, shall seek such third party liability payment before submitting claims to Subcontractor and/or Health Plan. Provider understands and agrees that each claim Provider submits to Subcontractor and/or Health Plan constitutes a certification that the claim is true and accurate to the best of Provider’s knowledge and belief and that the Covered Services are: 1) Medically Necessary; and 2) have been provided to the Covered Person prior to submitting the claim.
Claims Information. Provider shall promptly submit to United the information needed to make payment and shall identify third party liability coverage, including Medicare and other insurance, and if applicable seek such third party liability payment before submitting claims to United. Provider understands and agrees that each claim Provider submits to United constitutes a certification that the claim is true and accurate to the best of Provider’s knowledge and belief and that the Covered Services are 1) Medically Necessary and 2) have been provided to the Covered Person prior to submitting the claim.
Claims Information. BRAD's obligations hereunder are subject to a Warranty claim to be submitted in writing to BRAD's warranty administrator, which claim shall include but not be limited to the following information:
Claims Information. Subcontractor or Health Plan, as applicable, shall pay Provider upon receipt of a clean claim properly submitted by Provider within the required time frames as specified in TCA 00-00-000 and the CRA, as may be amended from time to time.
Claims Information. Bombardier's obligations hereunder are subject to a Warranty claim to be submitted in writing to Bombardier's warranty administrator, which claim shall include but not be limited to the following information:
Claims Information. Provider shall promptly submit to Subcontractor the information needed to make payment and shall identify third party liability coverage, including Medicare and other insurance, and if applicable seek such third-party liability payment before submitting claims to Subcontractor.
Claims Information. Provider shall promptly submit to Subcontractor or Health Plan the information needed to make payment and shall identify third party liability coverage, including Medicare and other insurance, and if applicable seek such third party liability payment before submitting claims to Subcontractor or Health Plan. Provider understands and agrees that each claim Provider submits to Subcontractor constitutes a certification that the claim is true and accurate to the best of Provider’s knowledge and belief and that the Covered Services are 1) Medically Necessary and 2) have been provided to the Covered Person prior to submitting the claim. Effective July 1, 2014, Provider must submit claims within six (6) months from the date of service. Claims filed within the appropriate time frame but denied may be resubmitted to the Contractor within ninety (90) calendar days from the date of denial
Claims Information. Provider shall promptly submit to Subcontractor and/or Health Plan the information needed to make payment and shall identify third party liability coverage, including Medicare and other insurance, and, if applicable, shall seek such third party liability payment before submitting claims to Subcontractor or Health Plan. Provider understands and agrees that each claim Provider submits to Subcontractor and/or Health Plan constitutes a certification that the claim is true and accurate to the best of Provider’s knowledge and belief and that the Covered Services are 1) Medically Necessary and 2) have been provided to the Covered Person prior to submitting the claim. Claims information must be accompanied by an itemized accounting of the individual claims, included in the payment including, but not limited to the enrollee’s name, the date of service, the procedure code, the service units, the amount for reimbursement and the identification of Subcontractor and/or Health Plan.
Claims Information. Provider shall promptly submit to Health Plan and Subcontractor the information needed to make payment and shall identify third party liability coverage, including Medicare and other insurance, and if applicable seek such third party liability payment before submitting claims to Health Plan and Subcontractor. Provider understands and agrees that each claim Provider submits to Health Plan and Subcontractor constitutes a certification that the claim is true and accurate to the best of Provider’s knowledge and belief and that the Covered Services are 1) Medically Necessary and 2) have been provided to the Covered Person prior to submitting the claim. Provider agrees to have policies and procedures that recognize and accept Medicaid as the payer of last resort. Providers agrees not to bill Covered persons for Covered Services any amount greater than would be owed if the provider or referral provider provided the service directly as provided in 42 C.F.R. §§ 438.3(k) and 438.230(c)(1)-(2). Pursuant to the State Contract, Provider shall not submit claim or encounter data for Covered Services directly to the Department.
Claims Information. Consistent with 42 CFR 447.45, Provider shall submit all claims to Health Plan or Subcontractor no later than 12 months from the date of service for which Provider requests reimbursement. Provider shall submit to Subcontractor and/or Health Plan, as applicable, the information needed to make payment and shall identify third party liability coverage, including Medicare and other insurance, and if applicable seek such third party liability payment before submitting claims to Subcontractor and/or Health Plan. Provider understands and agrees that each claim Provider submits to Subcontractor and/or Health Plan constitutes a certification that the claim is true and accurate to the best of Provider’s knowledge and belief and that the Covered Services are 1) Medically Necessary and 2) have been provided to the Covered Person prior to submitting the claim.
