E. In the event a Billing Agency or Clearinghouse is authorized by the Provider to submit
electronic claims in the Provider's behalf, a written contract will be secured between the
parties detailing the Billing Agency or Clearinghouse's responsibilities to report
information as directed by the Provider. A copy of the contract will be furnished to the
Plan if requested. Both the Provider and the Billing Agency or Clearinghouse must
maintain a record of all electronic claims submitted for payment.
F. Any Billing Agency or Clearinghouse must be authorized in writing by the Provider to
submit claims, and must abide by the terms of this Agreement and enter into such an
Agreement as required by the Plan.
G. Should the provider engage the services of a Billing Agency and not a Clearinghouse,
The Provider and the Billing Agency agree that it is their obligation to research and
correct any and all billing discrepancies caused by either of them and to hold the Plan
harmless for any costs or expenses, including claims overpayments or other damages
incurred as a result of such billing discrepancies.
H. The Provider and Billing Agency or Clearinghouse agree to hold harmless and indemnify
the Plan from and against all suits or claims of liability and all damages arising from or
alleged to arise from the Provider's, Billing Agency’s or Clearinghouse's negligence.
I. Access to any and all claims data will be restricted to the Provider and its employees, the
Billing Agency or Clearinghouse and its employees, the Plan, or any third party as
deemed necessary by the Provider, so as to maintain confidentiality according to HIPAA
privacy guidelines and to preclude the filing of fraudulent claims.
J. Provider will require any billing agency, clearinghouse or other such agent, that is
permitted though an agreement with Provider to access Protected Health Information
maintained by Plan, to provide reasonable assurance, evidenced by written contract, that
such billing agency or clearinghouse will comply with the privacy and security
obligations of Provider and Plan with respect to Protected Health Information maintained
K. The Provider agrees that the submission of an electronic claim is a claim for payment and
that it assumes sole liability for misrepresentation or falsification of any record or other
information essential to that claim or that is required pursuant to this Agreement if such
misrepresentation or falsification is made by the Provider.
L. The Billing Agency or Clearinghouse agrees that the submission of an electronic claim is
a claim for payment and that it assumes sole liability for misrepresentation or
falsification of any record or other information essential to that claim or that is required
pursuant this Agreement if such misrepresentation or falsification is made by the Billing
Agency or Clearinghouse.
M. Should a misrepresentation or falsification occur of any record or other information
essential to any claim submitted by the Provider to the Plan via the Billing Agency or
Blue Cross & Blue Shield of Mississippi, A Mutual Insurance Company, Page 2 of 6
is an independent licensee of the Blue Cross and Blue Shield Association.