Laserfiche WebLink
end of the applicable term. <br />ors, A third party payor is any person or entity <br />Section 4.06 Third Party Pay <br />' for all or art of the services provided, <br />who has the legal responsibility for paying,ns~anCe p arriers, Medicaid, or other <br />including commercial health or liability sources. Except as provided in the <br />federal, state, local, and pnvate funding <br />ctor shall screen all clients and shall not bill the Department foar <br />Contract, Contra a ors. Contractor shall. ( ) <br />services eligible for reimbursement from third pc Plan and Medicaid if providing <br />enroll as a provider in Children s Health I~S pct that may be covered by those <br />approved services authonzed under the rovide assistance to <br />ro ams, and bill those plans for the covered services; (bo ess indicates possible <br />p ~ ams when the screening p <br />individuals to enroll in such progr <br />such ro ams; (c) allow clients that are otherwise eligibleorf~or <br />ehg~bihty for p ~ a deductible required by a third party pay , <br />Department services, but cannot pay <br />to the amount of the deductible and to bill the Department for <br />receive services up ent for any services eligible for Hurd party <br />the deductible; (d) not bill the Departm <br />til all a peals to third party payors have been exhausted; (e) <br />reimbursement un P a or reflecting attempts <br />maintain appropriate documentation from the third p~ pSe ices provided under <br />to obtain reimbursement; (f) bill all thud party payo <br />re submitting any request for reimbursement to Department; and <br />this Contract befo <br />rovide third party billing functions at no cost to the client. <br />(g) P <br />ARTICLE V TERMS AND CONDITIONS OF PAYMENT <br />Prom t Payment. Upon receipt of a timely, undisputed invo~ed <br />Section S.O1 P ent will pay Contractor. Payments <br />pursuant to this Contract, Departm <br />are contingent upon a signed Contract and will not exceed the to 0 <br />reimbursements a ent <br />authorized funds under this Contract. Contractor is entitle au ~ d by ~e <br />of <br />reimbursement only if the service, work, andlor product hale eContract. If those <br />erformed or provided pursuant to th <br />Department and p ent in accordance with the Texas <br />conditions are met, Department will make payor <br />law TEx. Gov'T. CODE, Chapter 2251). Contractor must comp~yo <br />prompt payment ( t a ent obligations <br />with TEx. Gov'T. CODE, Chapter 2251 regazding its promp p yin <br />s. Pa ment of invoices by the Department shall not consti anted <br />subcontractor y <br />ce tance or approval of Contractor's performance, and all m~ otces <br />ac p <br />Contractor's performance is subject to audit or review by the ep <br />withhold all or part of <br />Section 5.02 Withholding Payments. Dept for any ineligible expenditures <br />any payments to Contractor to offset reimburse ded to Deyartrnent, or if financial <br />or overpayments that Contractor has not re ~ not submitted by the date(s) due. <br />status report(s) required by the Department <br />a take re ayment from funds available under this Contract, active or <br />Department m y p ent obli atlons. <br />ex fired, in amounts necessary to fulfill Contractor's repaym S <br />P <br />edition Precedent to Requesting Payment. Contractor shall <br />Section 5.03 Co <br />se ro ram income, rebates, refunds, contract settlements, auditcludine an' <br />d~sbur p g <br />d interest earned on such funds before requesting cash payments in g <br />an <br />611212007 9 <br />General Provisions (Core Subrecipient 2008) <br />