Agenda - 05-17-2005-5k - Laserfiche WebLink

Browse Search

pertaining to or related to the performance and administration of the services and obligations set forth in this Agreement. Subject to and consistent with HIPAA privacy laws, Provider further agrees that BCBSNC has the right to use whatever audit methodology it determines appropriate.. BCBSNC's rights set forth in this Section 2.5 shall survive termination of this Agreement, 2.6 BCBSNC Independent Licensee of Association. Provider acknowledges its understanding that this Agreement constitutes a contract between the Provider and BCBSNC, that BCBSNC is an independent corporation operating under a license from the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans (the "Association") permitting BCBSNC to use the Blue Cross and/or Blue Shield service mark in the State of North Carolina, and that BCBSNC is not contracting as the agent of the Association. Provider further acknowledges and agrees that it has not entered into this Agreement based upon representations by any person, entity, or organization other than BCBSNC and that no person, entity or organization other than BCBSNC shall beheld accountable or liable to the Provider for any of BCBSNC's obligations to Provider set forth in this Agreement. This Section 2.6 shall not create any additional obligations whatsoever on the part of BCBSNC other than those obligations set forth under other provisions of this Agreement. 2.7 Compliance With BCBSNC Policies and Procedures. Provider agrees to comply with, and abide by the decisions of BCBSNC with respect to claims. Provider agrees to comply with and abide by all applicable BCBSNC programs, policies and procedures as maybe enacted and revised from time to time so long as Provider has prior notice of all such applicable BCBSNC programs, policies and procedures. Provider further agrees, upon request, to provide evidence of compliance with the requirements of any and all such BCBSNC programs, policies and procedures. 3. BCBSNC'S OBLIGATIONS. BCBSNC agrees either to perform, or to have performed by an authorized representative/agent, the following obligations: 3.1 Administrative Functions. Provide administrative, accounting, database management, reporting, and other functions necessary to the administration and performance of its obligations under this Agreement. 3.2 Processine Claims. To make reasonable efforts to process claims for Covered Services rendered by Provider to Members within thirty (30) days of BCBSNC's receipt of all information necessazy to process such claims. 3.3 Payment For Services. To pay Provider for Covered Services rendered to Members in accordance with the provisions of Section 2.4 and Exhibit 2.4 to this Agreement.