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Payment Adjustments
a. Request for Adjustment
Either party shall be entitled to request an adjustment of payment, if, within one hundred eighty (180) days from the date of payment, it notifies the other party in writing of the overpayment or underpayment and provides documentation substantiating such claim.
b. Payment Disputes
The parties shall work cooperatively and in good faith to resolve payment disputes on an informal basis within (insert time) of the first notification of a request for an adjustment of payment, pursuant to paragraph a. above. If this is unsuccessful, than any disputes concerning the claims of overpayment or underpayment shall be resolved in accordance with the Plan’s Dispute Resolution / Arbitration / Mediation) procedure referenced in section (insert #) to this Agreement.
c. Payments Final.
Except for those payments that have been submitted to (Dispute Resolution) process, in accordance with the foregoing, all payments shall be final.
d. Paying Adjustments
If the parties determine that Plan has underpaid Provider, Plan shall pay the underpaid amount within       ( insert deadline) of said determination. If the parties determine that the Plan has overpaid Provider, Provider shall reimburse Plan for the overpayment within ( insert deadline) of said determination.
e. No Offsets or Deductions without Permission
In no event shall Plan offset payments against, or deduct overpayments from, any other payments it owes to Provider unless Provider expressly permits Plan to do so in writing.

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With more than 30 years of experience in health care and hospital operations, marketing, and revenue cycle management, Maria Todd wrote the leading industry books on managed care contract analysis and negotiation  written for the medical group and hospital executive audience.   Find this book and others authored by Maria on Amazon.com

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