Overpayment Recovery. At XXXXX’ sole discretion, XXXXX may xxxx PROVIDER or Participating Provider for an Overpayment. PROVIDER shall be responsible to remit payment on such an Overpayment invoice within forty-five (45) days from receipt of invoice. Should XXXXX not receive payment within the aforementioned timeframe, XXXXX will, when legally permissible, automatically apply the Overpayment to other outstanding payables on PROVIDER’s account. XXXXX retains the right to seek assistance from various collection agencies and/or to suspend or permanently terminate PROVIDER from further participation in XXXXX’ network in accordance with the suspension and termination provisions set forth in this Agreement. Notwithstanding the foregoing, should this provision conflict with any applicable rules and regulations, said rules and regulations shall govern. Notwithstanding the foregoing, XXXXX’ Overpayment recovery efforts shall comply with any legislative or statutory timeframe(s) specified within the jurisdiction where services were provided.
Overpayment Recovery. In accordance with §3224-b of the New York State Insurance Laws, XXXXX may xxxx PROVIDER or Participating Provider for an Overpayment. PROVIDER shall be responsible to remit payment on such an Overpayment invoice within forty- five (45) days from receipt of invoice. Should XXXXX not receive payment within the aforementioned timeframe, XXXXX will, when legally permissible, automatically apply the Overpayment to other outstanding payables on PROVIDER’s account. XXXXX retains the right to seek assistance from various collection agencies and/or to suspend or permanently terminate PROVIDER from further participation in XXXXX’ network in accordance with the suspension and termination provisions set forth in this Agreement.
Overpayment Recovery. A. Except for amounts of $50 or less, when the Agency has determined that an employee has been overpaid, the Employer will provide written notice to the employee, which will include the following items:
Overpayment Recovery. If DBI determines that it has paid benefits to an ineligible person or paid more than the appropriate amount, DBI shall, with Employer’s full cooperation, undertake a good faith effort to recover such erroneous payment. For purposes of this provision, DBI shall have the sole discretion to determine what constitutes a “good faith effort,” which effort may vary from time to time depending upon the circumstances of the overpayment, but may include DBI’s attempt to contact the participant twice via letter, phone, email or another means about the recovery of the payment at issue.
Overpayment Recovery. We may recover any overpayment we make for Services from:
Overpayment Recovery. The CHC-MCO shall audit, review and investigate Providers within its Network. The CHC-MCO shall recover any overpayments directly from its Network Providers for audits, reviews or investigations conducted solely by the CHC-MCO. o The CHC-MCO will void Encounters for those claims involving full recovery of the payment and adjust Encounters for partial recoveries. o The CHC-MCO must report all voids and adjustments to Encounters to the Department • The Department may audit, review and investigate MA Providers within the CHC-MCO’s Network. o The Department will develop a process to coordinate audits, reviews or investigations of Network Providers to avoid duplication of effort.
Overpayment Recovery. Payor(s). For purposes of this section, "refund" means the return, either directly or through an offset to a future claim, of some or all of a payment already received by a Practitioner.
Overpayment Recovery. If the City notifies the represented employee of the overpayment before the end of the pay period following the overpayment and gives the represented employee a correct paycheck, the represented employee shall, within five (5) calendar days of receiving the notice of overpayment and the correct paycheck, return to the City the full amount of the overpayment.
Overpayment Recovery. Hospital shall report to ACOH when it has received an overpayment, notify ACOH in writing of the reason for the overpayment, and return the overpayment to ACOH within sixty (60) calendar days after the date on which the overpayment was identified. The Agency may recover any overpayment paid from ACOH to Hospital if the Agency identifies the overpayment during the five-year period immediately following the end of the state fiscal year in which the overpayment was made, consistent with O.R.C. §5164.57.
Overpayment Recovery. We may recover any overpayment we make for Services from anyone who receives such an overpayment, or from any person or organization obligated to pay for the Services, to the extent that if written authorization, except as described in our Notice of Privacy Practices (see below). Giving us authorization is at your discretion. This is only a brief summary of some of our key privacy practices. Our Notice of Privacy Practices which provides additional information about our privacy practices and your rights regarding your PHI, is available and will be furnished to you upon request. To request a copy, please call our Member Service Call Center (see below). You can also find the notice at your local Plan Facility or on our Web site at xxx.xx.xxx. Inside Washington, D.C., Metropolitan area (000) 000-0000, or in the Baltimore, Maryland TTY (000) 000-0000 Outside the Washington, D.C. Metropolitan area 0-000-000-0000 XXXXXX FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. By: we have made payment to a health care provider, we may only retroactively deny reimbursement to the health care provider during the 6-month period after the date we paid the claim submitted by the health care provider. Privacy Practices Xxxxxx Permanente will protect the privacy of your protected health information (PHI). We also require contracting providers to protect your PHI. Your PHI is individually identifiable information about your health, health care services you receive, or payment for your health care. You may generally see and receive copies of your PHI, correct or update your PHI, and ask us for an accounting of certain disclosures of your PHI. We may use or disclose your PHI for treatment, payment, health research and health care operations purposes, such as measuring the quality of Services. We are sometimes required by law to give PHI to others, such as government agencies or in judicial actions. In addition, Member-identifiable health information is shared with your Group only with your authorization or as otherwise permitted by law. We will not use or disclose your PHI for any other purpose without your (or your representative’s) Xxxx Xxxxxxxx Vice President, Marketing, Sales & Business Development Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
