Adverse Actions Related to Requests for Services and Coverage Denials Sample Clauses

Adverse Actions Related to Requests for Services and Coverage Denials. The Contractor shall provide the Member written notice that meets the language and formatting requirements for Member materials, of any adverse Action (not just service authorization actions) within the timeframes for each type of Action pursuant to 42 CFR 438.210(c). The notice must explain:
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Related to Adverse Actions Related to Requests for Services and Coverage Denials

  • ERRORS AND OMISSIONS RELATED TO DATA 7.1.0 Board errors and retroactive adjustments shall be the responsibility of the Board.

  • Errors, Questions, and Complaints a. In case of errors or questions about your transactions, you should as soon as possible contact us as set forth in Section 6 of the General Terms above.

  • May Omit Grievance Steps An employee considered by the Union to be wrongfully or unjustly discharged or suspended shall be entitled to a hearing under Article 6, Grievance Procedure and Step 1 of the Grievance Procedure shall be omitted in such cases.

  • PROFESSIONAL RESPONSIBILITY (APPLIES TO RNS ONLY 19.01 The parties agree that resident care is enhanced if concerns relating to professional practice and workload are resolved in a timely and effective manner, as set out below; In the event that the Home assigns a number of residents or a workload to an individual employee or group of employees, such that she or they have cause to believe that she or they are being asked to perform more work than is consistent with proper resident care, she or they shall:

  • CONTRACTOR RESPONSIBILITY PROVISIONS For the purpose of these provisions, the term contractor is defined as any person, including, but not limited to, a bidder, offeror, loan recipient, grantee or lessor, who has furnished or performed or seeks to furnish or perform, goods, supplies, services, leased space, construction or other activity, under a contract, grant, lease, purchase order or reimbursement agreement with the Commonwealth of Pennsylvania (Commonwealth). The term contractor includes a permittee, licensee, or any agency, political subdivision, instrumentality, public authority, or other public entity in the Commonwealth.

  • Certification Regarding Responsibility Matters This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.

  • Required Procurement Procedures for Obtaining Goods and Services The Grantee shall provide maximum open competition when procuring goods and services related to the grant-assisted project in accordance with Section 287.057, Florida Statutes.

  • ADMISSION REQUIREMENTS FOR SENIOR COLLEGE PROGRAM  The A.A. degree and a minimum GPA of 2.00  Grade of C or better in a credit-bearing mathematics course worth three or more credits*  Grade of C or better in freshman composition, its equivalent, or a higher-level English course* *(Effective 10/1/08, per University policy) Students who wish to transfer but do not meet all of the above requirements or are unable to enroll within two years after graduation will receive admission consideration under our standard transfer credit policies. Total transfer credits granted toward the baccalaureate degree: 60 Total additional credits required at the senior college to complete baccalaureate degree: 60 Total credits required for the B.A. in Global History: 120

  • Procurement Related Complaints and Administrative Review 49.1 The procedures for making a Procurement-related Complaint are as specified in the TDS.

  • Grievance on Layoffs and Recalls Grievances concerning layoffs and recalls shall be initiated at Step 2 of the grievance procedure.

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