Common use of Electronic Services Clause in Contracts

Electronic Services. Health Plan shall make available a variety of services, at Health Plan’s discretion or as dictated by law, that Trading Partner may utilize via electronic media. Trading Partner’s access is only on behalf of an end user (health care services provider or employer group) that has engaged Trading Partner and has entered into a legally-sufficient Business Associate Agreement with Trading Partner authorizing Trading Partner to engage in electronic transactions on behalf of the end user. Health Plan shall have the right to request and promptly receive a copy of the Business Associate Agreement between any end user and Trading Partner and to terminate this Agreement if a Business Associate Agreement is not supplied or is not deemed legally-sufficient by Health Plan, or if the end user terminates its agreement with Trading Partner to conduct electronic transactions on its behalf. Health Plan will offer electronic connectivity to Trading Partner for the performance of agreed- upon transactions. Health Plan may change the scope of electronic services offered by Health Plan from time to time without advanced notice and without consent of Trading Partner. In conducting electronic transactions, the parties must use the code sets, data elements, formats, and instructions specified in the applicable ANSI X12N Implementation Guide(s). Health Plan will supply Trading Partner with any Companion Guide(s) or other document(s) developed by Health Plan to communicate business requirements not specifically addressed in the ANSI X12N 7/10/13 Implementation Guide(s). Health Plan will reject any transaction that does not satisfy the current formats, specifications, and technical and edit requirements set forth in the applicable ANSI X12N Implementation Guide(s) and Companion Guide(s) or other Health Plan document(s) developed for electronic trading partners by Health Plan. The provisions of the applicable ANSI X12N Implementation Guide(s) and any Companion Guide(s) or other document(s) developed for electronic trading partners by Health Plan are specifically incorporated by reference into this Agreement. If an electronic transaction conducted between Health Plan and Trading Partner is not a compliant transaction, Health Plan shall reject the transaction, or batch of transactions, with the corresponding HIPAA code or codes that apply to the particular transaction at issue. Trading Partner is responsible for retrieving transaction response reports, which will provide information about transaction denials and other file format issues. Health Plan will not monitor validation errors. Trading Partner shall be responsible for, and Health Plan may bill Trading Partner for, any and all fees or penalties imposed upon Health Plan as a result of inappropriate transactions submitted by Trading Partner to Health Plan. All security codes, instruction manuals and other materials that Health Plan provides to Trading Partner, including those of any Health Plan subcontractor, shall remain the property of Health Plan and shall be returned to Health Plan upon demand, together with copies of the foregoing and any backup files and data.

Electronic Services. Health Plan shall make available a variety of services, at Health Plan’s discretion or as dictated by law, services that Trading Partner may utilize via electronic media. Trading Partner’s access is only on behalf of an end user (health care services provider or employer group) that has engaged Trading Partner and has entered into a legally-sufficient Business Associate Agreement with Trading Partner authorizing Trading Partner to engage in electronic transactions on behalf of the end user. The services, which Health Plan shall have offer via electronic media, will include but not be limited to, the right to request and promptly receive receipt of claims for payment, reports from Health Plan regarding the status of those claims (claims functions), payment/remittance advice, as well as a copy variety of the Business Associate Agreement between any end user and Trading Partner and to terminate this Agreement if a Business Associate Agreement is not supplied or is not deemed legally-sufficient by Health Plan, or if the end user terminates its agreement with Trading Partner to conduct electronic transactions on its behalfgroup related transactions. Health Plan will offer an electronic connectivity service referred to as “Quicklink” whereby Trading Partner may perform inquiry functions regarding the status of a claim(s) or an individual’s eligibility for the performance of agreed- upon transactionsbenefits under a health insurance policy issued by Health Plan. Health Plan may change the scope of electronic services offered by Health Plan from time to time without advanced notice and without consent of Trading Partner. In conducting If an electronic transactionstransaction, conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate, is a Standard Transaction as defined by Section 1173(a) of the Social Security Act, the parties Parties must use the code sets, data elements, formats, formats and instructions specified in the applicable ANSI X12N Implementation Guide(s)Guide. Health Plan will supply Trading Partner with any Companion Guide(s) Guide or other document(s) document developed by Health Plan to communicate business requirements not specifically addressed in the ANSI X12N 7/10/13 Implementation Guide(s)Guides. Health Plan will reject any transaction Standard Transaction that does not satisfy the current formats, specifications, and technical and edit requirements set forth in the applicable ANSI X12N Implementation Guide(s) and Companion Guide(s) or other Health Plan document(s) developed for electronic trading partners by Health Plan. The provisions of the applicable ANSI X12N Implementation Guide(s) and any Companion Guide(s) or other document(s) developed for electronic trading partners by Health Plan are specifically incorporated by reference into this AgreementGuide. If an electronic transaction conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate is not a compliant transactionStandard Transaction, Health Plan shall reject notify Trading Partner of the transactionformats, or batch specifications, technical and edit requirements, and any related conditions (including those of transactionsany subcontractor), with the corresponding HIPAA code or codes that apply to the particular transaction at issue. Trading Partner is responsible for retrieving transaction response reports, reports which will provide information about transaction denials and other file format issues. Health Plan will not monitor validation errors. Trading Partner shall be responsible forIn addition to the fees set forth in Schedule A (if any), and Health Plan may can bill Trading Partner for, any and all for fees or penalties imposed upon Health Plan as a result of inappropriate transactions submitted by Trading Partner to Health Plan. All security codes, instruction manuals and other materials that which Health Plan provides to Trading Partner, including those of any Health Plan subcontractor, shall remain the property of Health Plan and shall be returned to Health Plan upon demand, together with copies of the foregoing and any backup files and data.

Electronic Services. Health Plan shall make available a variety of services, at Health Plan’s discretion or as dictated by law, services that Trading Partner may utilize via electronic media. Trading Partner’s access is only on behalf of an end user (health care services provider or employer group) that has engaged Trading Partner and has entered into a legally-sufficient Business Associate Agreement with Trading Partner authorizing Trading Partner to engage in electronic transactions on behalf of the end user. The services, which Health Plan shall have offer via electronic media, shall include but not be limited to, the right to request and promptly receive a copy receipt of the Business Associate Agreement between any end user and Trading Partner and to terminate this Agreement if a Business Associate Agreement is not supplied or is not deemed legally-sufficient by Health Planclaims for payment, or if the end user terminates its agreement with Trading Partner to conduct electronic transactions on its behalf. reports from Health Plan will offer electronic connectivity to Trading Partner for regarding the performance status of agreed- upon those claims (claims functions), payment/remittance advice, as well as a variety of group related transactions. Health Plan may change the scope of electronic services offered by Health Plan from time to time without advanced advance notice and without consent of Trading Partner. In conducting If an electronic transactionstransaction, conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate, is a Standard Transaction as defined by Section 1173(a) of the Social Security Act, the parties Parties must use the code sets, data elements, formats, formats and instructions specified in the applicable ANSI X12N Implementation Guide(s)Guide. Health Plan will shall supply Trading Partner with any Companion Guide(s) Guide or other document(s) document developed by Health Plan to communicate business requirements not specifically addressed in the ANSI X12N 7/10/13 Implementation Guide(s)Guides. Health Plan will shall reject any transaction Standard Transaction that does not satisfy the current formats, specifications, and technical and edit requirements set forth in the applicable ANSI X12N Implementation Guide(s) and Companion Guide(s) or other Health Plan document(s) developed for electronic trading partners by Health Plan. The provisions of the applicable ANSI X12N Implementation Guide(s) and any Companion Guide(s) or other document(s) developed for electronic trading partners by Health Plan are specifically incorporated by reference into this AgreementGuide. If an electronic transaction conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate is not a compliant transactionStandard Transaction, Health Plan shall reject notify Trading Partner of the transactionformats, or batch specifications, technical and edit requirements, and any related conditions (including those of transactionsany subcontractor), with the corresponding HIPAA code or codes that apply to the particular transaction at issue. Trading Partner is responsible for retrieving transaction response reports, reports which will shall provide information about transaction denials and other file format issues. Health Plan will shall not monitor validation errors. Trading Partner shall be responsible forIn addition to the fees set forth in Schedule A (if any), and Health Plan may bill Trading Partner for, any and all for fees or penalties imposed upon Health Plan as a result of inappropriate transactions submitted by Trading Partner to Health Plan. All security codes, instruction manuals and other materials that which Health Plan provides to Trading Partner, including those of any Health Plan subcontractor, shall remain the property of Health Plan and shall be returned to Health Plan upon demand, together with copies of the foregoing and any backup files and data.

Electronic Services. Health Plan shall make available a variety of services, at Health Plan’s discretion or as dictated by law, that Trading Partner may utilize via electronic media. Trading Partner’s access is only on its own behalf of as an end user (health care services provider or employer group) that has engaged user; Trading Partner and has entered into a legally-sufficient Business Associate Agreement with Trading Partner authorizing Trading Partner is not authorized to engage in electronic transactions access the services made available by Health Plan on behalf of the end user. Health Plan shall have the right to request and promptly receive a copy of the Business Associate Agreement between any end user and Trading Partner and to terminate this Agreement if a Business Associate Agreement is not supplied other individuals or is not deemed legally-sufficient by Health Planorganizations (for example, or if the end user terminates its agreement with Trading Partner to conduct electronic transactions on its behalfcollections agencies). Health Plan will offer electronic connectivity to Trading Partner for the performance of agreed- upon transactions. Health Plan may change the scope of electronic services offered by Health Plan from time to time without advanced notice and without consent of Trading Partner. In conducting electronic transactions, the parties must use the code sets, data elements, formats, and instructions specified in the applicable ANSI X12N Implementation Guide(s). Health Plan will supply Trading Partner with any Companion Guide(s) or other document(s) developed by Health Plan to communicate business requirements not specifically addressed in the ANSI X12N 7/10/13 Implementation Guide(s). Health Plan will reject any transaction that does not satisfy the current formats, specifications, and technical and edit requirements set forth in the applicable ANSI X12N Implementation Guide(s) and Companion Guide(s) or other Health Plan document(s) developed for electronic trading partners by Health Plan. The provisions of the applicable ANSI X12N Implementation Guide(s) and any Companion Guide(s) or other document(s) developed for electronic trading partners by Health Plan are specifically incorporated by reference into this Agreement. If an electronic transaction conducted between Health Plan and Trading Partner is not a compliant transaction, Health Plan shall reject the transaction, or batch of transactions, with the 7/10/13 corresponding HIPAA code or codes that apply to the particular transaction at issue. Trading Partner is responsible for retrieving transaction response reports, which will provide information about transaction denials and other file format issues. Health Plan will not monitor validation errors. Trading Partner shall be responsible for, and Health Plan may bill Trading Partner for, any and all fees or penalties imposed upon Health Plan as a result of inappropriate transactions submitted by or on behalf of Trading Partner to Health Plan. All security codes, instruction manuals and other materials that Health Plan provides to Trading Partner, including those of any Health Plan subcontractor, shall remain the property of Health Plan and shall be returned to Health Plan upon demand, together with copies of the foregoing and any backup files and data.

Electronic Services. Health Plan shall make available a variety of services, at Health Plan’s discretion or as dictated by law, services that Trading Partner may utilize via electronic media. Trading Partner’s access is only on behalf of an end user (health care services provider or employer group) that has engaged Trading Partner and has entered into a legally-sufficient Business Associate Agreement with Trading Partner authorizing Trading Partner to engage in electronic transactions on behalf of the end user. The services, which Health Plan shall have offer via electronic media, will include but not be limited to, the right to request and promptly receive receipt of claims for payment, reports from Health Plan regarding the status of those claims (claims functions), payment/remittance advice, as well as a copy variety of the Business Associate Agreement between any end user and Trading Partner and to terminate this Agreement if a Business Associate Agreement is not supplied or is not deemed legally-sufficient by Health Plan, or if the end user terminates its agreement with Trading Partner to conduct electronic transactions on its behalfgroup related transactions. Health Plan will offer an electronic connectivity service referred to as “Quicklink” whereby Trading Partner may performinquiry functions regarding the status of a claim(s) or an individual’s eligibility for the performance of agreed- upon transactionsbenefits under a health insurance policy issued by Health Plan. Health Plan may change the scope of electronic services offered by Health Plan from time fromtime to time without advanced notice and without consent of Trading Partner. In conducting If an electronic transactionstransaction, conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate, is a Standard Transaction as defined by Section 1173(a) of the Social Security Act, the parties Parties must use the code sets, data elements, formats, formats and instructions specified in the applicable ANSI X12N Implementation Guide(s)Guide. Health Plan will supply Trading Partner with any Companion Guide(s) Guide or other document(s) document developed by Health Plan to communicate business requirements not specifically addressed in the ANSI X12N 7/10/13 Implementation Guide(s)Guides. Health Plan will reject any transaction Standard Transaction that does not satisfy the current formats, specifications, and technical and edit requirements set forth in the applicable ANSI X12N Implementation Guide(s) and Companion Guide(s) or other Health Plan document(s) developed for electronic trading partners by Health Plan. The provisions of the applicable ANSI X12N Implementation Guide(s) and any Companion Guide(s) or other document(s) developed for electronic trading partners by Health Plan are specifically incorporated by reference into this AgreementGuide. If an electronic transaction conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate is not a compliant transactionStandard Transaction, Health Plan shall reject notify Trading Partner of the transactionformats, or batch specifications, technical and edit requirements, and any related conditions (including those of transactionsany subcontractor), with the corresponding HIPAA code or codes that apply to the particular transaction at issue. Trading Partner is responsible for retrieving retriev ing transaction response reports, reports which will provide information about transaction denials and other file format issues. Health Plan will not monitor validation errors. In addition to the fees set forth in Schedule A (if any), Health Plan can xxxx Trading Partner shall be responsible for, and Health Plan may bill Trading Partner for, any and all for fees or penalties imposed upon Health Plan as a result of inappropriate transactions submitted by Trading Partner to Health Plan. All security codes, instruction manuals and other materials that which Health Plan provides to Trading Partner, including those of any Health Plan subcontractor, shall remain the property of Health Plan and shall be returned to Health Plan upon demand, together with copies of the foregoing and any backup files and data.

Electronic Services. Health Plan shall make available a variety of services, at Health Plan’s discretion or as dictated by law, services that Trading Partner may utilize via electronic media. Trading Partner’s access is only on behalf of an end user (health care services provider or employer group) that has engaged Trading Partner and has entered into a legally-sufficient Business Associate Agreement with Trading Partner authorizing Trading Partner to engage in electronic transactions on behalf of the end user. The services, which Health Plan shall have offer via electronic media, shall include but not be limited to, the right to request and promptly receive a copy receipt of the Business Associate Agreement between any end user and Trading Partner and to terminate this Agreement if a Business Associate Agreement is not supplied or is not deemed legally-sufficient by Health Planclaims for payment, or if the end user terminates its agreement with Trading Partner to conduct electronic transactions on its behalf. reports from Health Plan will offer electronic connectivity to Trading Partner for regarding the performance status of agreed- upon those claims (claims functions), payment/remittance advice, as well as a variety of group related transactions. Health Plan may change the scope of electronic services offered by Health Plan from time to time without advanced advance notice and without consent of Trading Partner. In conducting If an electronic transactionstransaction, conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate, is a Standard Transaction as defined by Section 1173(a) of the Social Security Act, the parties Parties must use the code sets, data elements, formats, formats and instructions specified in the applicable ANSI X12N Implementation Guide(s)Guide. Health Plan will shall supply Trading Partner with any Companion Guide(s) Guide or other document(s) document developed by Health Plan to communicate business requirements not specifically addressed in the ANSI X12N 7/10/13 Implementation Guide(s)Guides. Health Plan will shall reject any transaction Standard Transaction that does not satisfy the current formats, specifications, and technical and edit requirements set forth in the applicable ANSI X12N Implementation Guide(s) and Companion Guide(s) or other Health Plan document(s) developed for electronic trading partners by Health Plan. The provisions of the applicable ANSI X12N Implementation Guide(s) and any Companion Guide(s) or other document(s) developed for electronic trading partners by Health Plan are specifically incorporated by reference into this AgreementGuide. If an electronic transaction conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate is not a compliant transactionStandard Transaction, Health Plan shall reject notify Trading Partner of the transactionformats, or batch specifications, technical and edit requirements, and any related conditions (including those of transactionsany subcontractor), with the corresponding HIPAA code or codes that apply to the particular transaction at issue. Trading Partner is responsible for retrieving transaction response reports, reports which will shall provide information about transaction denials and other file format issues. Health Plan will shall not monitor validation errors. Trading Partner shall be responsible forIn addition to the fees set forth in Schedule A (if any), and Health Plan may bill xxxx Trading Partner for, any and all for fees or penalties imposed upon Health Plan as a result of inappropriate transactions submitted by Trading Partner to Health Plan. All security codes, instruction manuals and other materials that which Health Plan provides to Trading Partner, including those of any Health Plan subcontractor, shall remain the property of Health Plan and shall be returned to Health Plan upon demand, together with copies of the foregoing and any backup files and data.

Electronic Services. Health Plan shall make available a variety of services, at Health Plan’s discretion or as dictated by law, services that Trading Partner may utilize via electronic media. Trading Partner’s access is only on behalf of an end user (health care services provider or employer group) that has engaged Trading Partner and has entered into a legally-sufficient Business Associate Agreement with Trading Partner authorizing Trading Partner to engage in electronic transactions on behalf of the end user. The services, which Health Plan shall have offer via electronic media, will include but not be limited to, the right to request and promptly receive receipt of claims for payment, reports from Health Plan regarding the status of those claims (claims functions), payment/remittance advice, as well as a copy variety of the Business Associate Agreement between any end user and Trading Partner and to terminate this Agreement if a Business Associate Agreement is not supplied or is not deemed legally-sufficient by Health Plan, or if the end user terminates its agreement with Trading Partner to conduct electronic transactions on its behalfgroup related transactions. Health Plan will offer an electronic connectivity service referred to as “Quicklink” whereby Trading Partner may performinquiry functions regarding the status of a claim(s) or an individual’s eligibility for the performance of agreed- upon transactionsbenefits under a health insurance policy issued by Health Plan. Health Plan may change the scope of electronic services offered by Health Plan from time fromtime to time without advanced notice and without consent of Trading Partner. In conducting If an electronic transactionstransaction, conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate, is a Standard Transaction as defined by Section 1173(a) of the Social Security Act, the parties Parties must use the code sets, data elements, formats, formats and instructions specified in the applicable ANSI X12N Implementation Guide(s)Guide. Health Plan will supply Trading Partner with any Companion Guide(s) Guide or other document(s) document developed by Health Plan to communicate business requirements not specifically addressed in the ANSI X12N 7/10/13 Implementation Guide(s)Guides. Health Plan will reject any transaction Standard Transaction that does not satisfy the current formats, specifications, and technical and edit requirements set forth in the applicable ANSI X12N Implementation Guide(s) and Companion Guide(s) or other Health Plan document(s) developed for electronic trading partners by Health Plan. The provisions of the applicable ANSI X12N Implementation Guide(s) and any Companion Guide(s) or other document(s) developed for electronic trading partners by Health Plan are specifically incorporated by reference into this AgreementGuide. If an electronic transaction conducted between Health Plan and Trading Partner or Trading Partner’s agent/Business Associate is not a compliant transactionStandard Transaction, Health Plan shall reject notify Trading Partner of the transactionformats, or batch specifications, technical and edit requirements, and any related conditions (including those of transactionsany subcontractor), with the corresponding HIPAA code or codes that apply to the particular transaction at issue. Trading Partner is responsible for retrieving retriev ing transaction response reports, reports which will provide information about transaction denials and other file format issues. Health Plan will not monitor validation errors. Trading Partner shall be responsible forIn addition to the fees set forth in Schedule A (if any), and Health Plan may can bill Trading Partner for, any and all for fees or penalties imposed upon Health Plan as a result of inappropriate transactions submitted by Trading Partner to Health Plan. All security codes, instruction manuals and other materials that which Health Plan provides to Trading Partner, including those of any Health Plan subcontractor, shall remain the property of Health Plan and shall be returned to Health Plan upon demand, together with copies of the foregoing and any backup files and data.