Crossover Agreement Meaning

Guidelines on changes to the National Benefit Coordination Agreement (COBRA) crossover process, including removing applications that are completely rejected, modifying the common system to ensure they do not generate provider notification letters when certain error codes are generated, a more detailed explanation of previous statements, and how to change data filling routines for Outgoing cross-files. This term may include TennCare providers who provide services outside of the managed care program on a fee-for-service basis, as well as TennCare providers who receive Medicare cross-payments from TennCare. Medicare cross-requests and Medicaid managed care meeting requests are excluded. Nevada Medicaid does not register suppliers to offer mail-order delivery of durable pharmaceutical or medical equipment or gases, except for those that provide services only to Medicare cross-beneficiaries. This includes, but is not limited to, reimbursement only for Medicare cross-claims (i.e., claims relating to “eligible” beneficiaries covered by both Medicare and Medicaid). An application may be rejected. As part of Order Assignments, the Customer may modify this Agreement with contracts that require your consent prior to the provision of the Services. Agreements may include ownership information agreements (assignment of intellectual property to Customer similar to this Agreement), codes of conduct, data protection agreements and other policies (the “Customer Agreements”). You should review all customer agreements provided to you. If you do not agree with these customer agreements, you must inform the customer. If you are not eligible for a work assignment due to your rejection (as determined only by the client), your work order will be cancelled and you will be able to apply for another job. CUSTOMER CONTRACTS ARE BINDING ON YOU AND YOU MUST READ AND COMPLY WITH THEM CAREFULLY. CROSSOVER IS NOT A PARTY TO ANY CUSTOMER AGREEMENT AND HAS NO RIGHTS OR OBLIGATIONS TO YOU OR THE CUSTOMER UNDER SUCH CUSTOMER AGREEMENTS.

1.3. “Terms and Conditions” means the online or written service or license agreement between Licensee and Crossover that contains a reference or link to this Agreement. MHD has developed an easy-to-use web-based tool to customize miscalculated and/or paid Medicaid and Medicare cross-claims. 1.2 “WorkSmart System Update” means any enhancements, modifications, service packs, patches or new versions issued by Crossover in its sole discretion. Updates to the WorkSmart system are subject to the terms of the license agreement accompanying the notification of the availability of such WorkSmart system update or, if it is not available, to the current version of this agreement, in which case the above definition of “WorkSmart system update” will be deemed included in the definition of “WorkSmart system” above. CMS adjusts fee schedules each year to account for changes in the Consumer Price Index for all urban customers.79.1(22) Medicare cross-fees for inpatient and outpatient hospital services. 13.1 This Agreement and all documents referenced in this Agreement constitute the complete and exclusive statement of the Terms with respect to the Services and supersede all prior discussions, writings, agreements and negotiations with respect to the subject matter. NON-TENNCARE PROVIDER means a provider that is not registered with TennCare and does not accept TennCare reimbursement for any service, including Medicare cross-payments. Ratings that cannot be assigned to a RUG III group due to errors are excluded from both calculations of the average case mix index.81.6 (20) Medicare crossover entitlements for care facility services.a. Definitions. For the purpose of calculating the percentage of Medicaid use by inpatients, Medicaid days include kindergarten days and individual psychiatric units, but not Medicare cross-days. 7.6 You must comply with all U.S.

and international laws governing or relating to data protection, data security, and the handling of customer information and data breaches. You have stated that you have put in place appropriate security and verification procedures to ensure compliance with such laws, rules and regulations, and that you will use such procedures in connection with the Services to be provided under this Agreement. Subject to Customer`s request, you must take all commercially reasonable steps to ensure that Customer complies with its obligations as a data controller in accordance with applicable data protection laws. If a country in which the services are to be provided under this Agreement has or enacts a data protection law that requires the execution of a data processing agreement, you must immediately enter into such data processing agreement under the terms requested by the customer. 11.6 This Agreement and the applicable Service Agreement constitute the entire agreement between the parties and supersede all prior or contemporaneous written or oral discussions, statements and proposals relating to the subject matter of this Agreement. This Agreement may not be modified or modified in any way unless approved in writing and signed by an authorized representative of the parties. For MSC+, this includes payment from the MCO for cross-claims for Medicare. 13.4 The headings are provided for reference purposes only and have no substantial effect.

10.1 IN NO EVENT SHALL OUR COMPANY, THE CUSTOMER OR ITS AFFILIATES BE LIABLE UNDER ANY THEORY OF LIABILITY, WHETHER IN EQUITY, LEGAL ACTION OR CUSTOMARY ARISING OUT OF THIS AGREEMENT, STRICT LIABILITY, INDEMNIFICATION, TORT (INCLUDING NEGLIGENCE) OR OTHERWISE, FOR DAMAGES IN EXCESS OF THE TOTAL AMOUNT OUR COMPANY HAS RECEIVED UNDER THE ORDER, WHO RAISES THE GROUND OF APPEAL AND PAYS NOTWITHSTANDING THE FAILURE OF THE ESSENTIAL SUBJECT-MATTER OF AN APPEAL. 11.8 All notices and requests relating to this Agreement to be sent to Crossover must be in writing and sent by hand delivery, overnight courier or registered letter with proof of delivery to the following address: 6.3 If our Company or a Customer provides computers, hardware, software, telephone or other tools (collectively, the “Borrowed Devices”), these will continue to be our property and you will become the Use company`s equipment only in accordance with this agreement and the company`s code of conduct for independent contractors, as well as the code of conduct shared by the customer. Unless otherwise agreed in writing, you must return the rented equipment at the end of the respective order or earlier if requested by our company or the customer. You agree that our company may withhold any remaining payment until you return any borrowed equipment or confidential information in your possession. 5.2 In the event that the Inventions are not considered “Commissioned Works”, you irrevocably grant, transfer and transfer to the Client all right, title and interest of any kind in the Inventions. You will further assist the Customer in proving, recording and perfecting such assignments and in perfecting, maintaining, maintaining, enforcing and defending all transferred rights. You irrevocably appoint and appoint the Client and its agents as beneficial counsel acting for and on your behalf to execute and file a document and take all other legally permitted steps to advance the foregoing with the same legal force and effect as if it had been carried out by you. If such assistance from you occurs after the expiration or termination of this Agreement, you will receive a reasonable hourly fee (and pre-approved costs out of pocket) for such assistance. 3.1 If a timesheet is required in the work assignment, be sure to complete a timesheet for each day you provide the Services and submit it to us.

Sometimes we require an invoice to be attached to each timesheet. Payments are scheduled at the frequency specified in the order assignment. You acknowledge that we may designate a third party to process all payments made to you under this Agreement. HHS strives to make its websites and materials accessible to the widest possible public, including persons with disabilities. We are in the process of making some documents available retroactively. If you require assistance in accessing an accessible version of this document, please contact Section 508 Support. 13.7 For a notice under this Agreement to be valid, it must be in writing (including electronic communications). All notices shall be deemed effective upon service on the affected party. We may send you communications to (a) your physical address provided on the first page or (b) your email address. Unless otherwise stated, all communications to our company must be sent by e-mail to the e-mail address specified in the order order.

9.1 Our company is only interested in putting you in touch with customers. The results of the services you provide; how and how to achieve results are under your sole control. With respect to others and with respect to services provided to customers, the parties are independent contractors for all purposes. There is no relationship between the agency, partnership, joint venture, employment or franchise between the parties or between you and the Company or between you and the Client. You may not bind our company or the customer or make any commitments on our behalf or on their behalf. Except as otherwise provided in this Agreement, you are responsible for all costs and expenses associated with the completion of the Services and must provide your own supplies and equipment. You acknowledge and agree that you are not entitled to the benefits of our company or the client company, including but not limited to group health insurance, workers` compensation, unemployment compensation, disability, liability or any other type of insurance. .