Notice of Adverse. Benefit Determination means written notification to an Enrollee and written or verbal notification to a Provider when applicable, of an Adverse Benefit Determination that will be taken by the Contractor. Notice of Appeal Resolution means written notification to an Enrollee, and a Provider when applicable, of the Contractor’s resolution of an Appeal. Office of Recovery Services (ORS) means an agency within the Utah Department of Human Services. Other Disclosing Entity means any other Medicaid disclosing entity and any entity that does not participate in Medicaid but is required to disclose certain ownership and control information because of participation in any of the programs established under Title V, XVIII, or XX of the Social Security Act. This includes:
Notice of Adverse. Benefit Determination means written notification to an Enrollee and written or verbal notification to a Provider when applicable, of an Adverse Benefit Determination that will be taken by the Contractor. Notice of Appeal Resolution means written notification to an Enrollee, and a Provider when applicable, of the Contractor’s resolution of an Appeal. NQF means the National Quality Forum. Office of Recovery Services (ORS) means an agency within the Department of Human Services.
Notice of Adverse. Recommendation Section 5.5 Other Filings Section 5.3 Parachute Payments Section 5.14 Parent Preamble Parent Termination Fee Section 7.3 Permits Section 3.12 Preferred Stock Section 3.3 Proxy Statement Section 5.3 Representatives Section 5.5 Required Company Stockholders Section 3.3 Xxxxxxxx-Xxxxx Act Section 3.5 SEC Section 3.5 State PUC Section 3.4 State PUC Consents Section 5.6 Surviving Corporation Section 1.1 Termination Date Section 7.1 Unicomm Acquisition Agreement Section 5.1 Voting Agreement Introduction
Notice of Adverse. Benefit Determination (NOABD) Contractors providing Medi-Cal services shall provide clients with Medi-Cal with a NOABD under the following circumstances:
Notice of Adverse. ACTION IPA shall promptly notify HMO in writing after receiving any written notice of any malpractice suit or arbitration action, or other suit or arbitration action with respect to Members naming or otherwise involving IPA Physician, IPA Hospital or IPA Ancillary Provider. 11 3.13 RECORD KEEPING Each IPA Provider shall maintain such records as are necessary for the evaluation of the quality, appropriateness, and timeliness of services performed under this Agreement. Said records will be made available for fiscal audit, medical audit, medical review, utilization review and other periodic monitoring upon request of authorized representatives of HMO. Said records shall be retained for a period of at least five (5) years after the expiration of this Agreement or until the resolution of any ongoing audit occurs, whichever is longer. Such records shall be provided for inspection to the Agency and HCFA or other appropriate state or federal agency. All records shall be maintained and safeguarded in compliance with 42 CFR Part 431, Subpart F. Any release of medical or other patient records in accordance with this Section 3.13 shall be subject to all applicable state and federal laws pertaining to and governing the confidentiality of such records including, without limitation, any applicable requirements regarding the consent of the patient or such patient's legal representative to the release of such records.
Notice of Adverse. At the time of either Borrower's first change in assets knowledge or notice, such Borrower shall immediately notify the Administrative Agent of any information that may adversely affect in any material manner the assets of either Borrower, including, but not limited to, the value or marketability of any Properties. 5.12
Notice of Adverse. Benefit Determination Requirements 327 A.2.14.8 Medical History Information Requirements 327 A.2.14.9 PCP Profiling 327 A.2.15 QUALITY MANAGEMENT/QUALITY IMPROVEMENT 328 A.2.15.1 Quality Management/Quality Improvement (QM/QI) Program 328 A.2.15.2 QM/QI Committee 330 A.2.15.3 Performance Improvement Projects (PIPs) 330 A.2.15.4 Clinical Practice Guidelines 331 A.2.15.5 NCQA Accreditation 332
