Advocacy Services Sample Clauses

The Advocacy Services clause defines the scope and nature of advocacy-related support that one party will provide to another under the agreement. Typically, this clause outlines the specific types of advocacy activities covered, such as representing the client in meetings, negotiations, or communications with third parties, and may set limits on the extent or duration of such services. Its core practical function is to clarify the expectations and boundaries of advocacy support, ensuring both parties understand what is included and preventing misunderstandings about the level of representation provided.
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Advocacy Services. Financial Evaluation for individuals who are applying for contractor's programs and/or screening for other financial aid programs offered to residents of this County.
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Advocacy Services. The Grantee shall operate a call center using a statewide toll-free advocacy phone line f or the purpose of providing information and assistance pertaining to TennCare eligibility and the annual renewal process. While this phone line will constitute the majority of incoming contact, the Grantee shall accept contacts made by TennCare applicants and members, and persons or agencies on behalf of TennCare applicants and members via telephone, mail, fax, and/or secure e-mail. Inf ormation and assistance provided shall include but is not limited to the renewal process, eligibility categories and requirements, and eligibility appeals. Inf ormation and assistance provided shall exclude eligibility verification for providers. a. This phone line shall be staffed by fluent English-speaking advocates who are trained and knowledgeable in customer service, conflict resolution, crisis de-escalation, and interpersonal and problem-solving skills. In addition, staff shall acquire and maintain proficiency in their knowledge of the TennCare program. b. At no additional cost to the State, the Grantee shall provide culturally and linguistically appropriate statewide TennCare assistance through the call center, specifically to persons with Limited English Proficiency (LEP) or to persons or agencies who act on behalf of TennCare applicants and members with LEP. For purposes of this grant, "persons with LEP" shall be defined as TennCare applicants and members who need assistance in a language other than English. (1) The Grantee shall operate a separate, menu-driven split/skill of the toll-free phone line f or TennCare assistance for Spanish-speaking TennCare applicants and members staffed by bilingual advocates fluent in Spanish and English, who are trained and knowledgeable as specified in Section A.6.a. (2) The Grantee shall provide and maintain access to free Interpreter Services for callers with LEP. (3) Interpreter Services shall be available during hours of operation as specified in Section A.6.e. (4) If the Grantee utilizes an outside source in providing Interpreter Services, this outside source shall be considered a subcontractor and shall comply with subcontractor requirements specified Section D.5, as well as the following additional requirements: i. The subcontractor shall ensure interpreters are trained according to professional and ethical standards, including confidentiality and the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). ii. The subcon...
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  • Pharmacy Services The Contractor agrees to comply with the requirements regarding covered pharmacy and over-the- counter (OTC) benefits. The Contractor will comply with the EOHHS Pharmacy Home Program and the Generics First Initiative, including the maintenance of the drug formulary in accordance with the direction of the EOHHS Pharmacy Committee.

  • OUR SERVICES As insurance intermediaries we generally act as the agent of our client. We are subject to the law of agency, which imposes various duties on us. However, in certain circumstances we may act for and owe duties of care to other parties, including the insurer. We will advise you when these circumstances occur, so you will be aware of any possible conflict of interest. We offer a wide range of products and services which may include: • Offering you a single or range of products from which to choose a product that suits your insurance needs; • Advising you on your insurance needs; • Arranging suitable insurance cover with insurers to meet your requirements; • Helping you with any subsequent changes to your insurance you have to make; • Providing all reasonable assistance with any claim you make. In some cases, we act for insurers under a delegated authority agreement and can enter into insurance policies, issue policy documentation and/or handle or settle claims on their behalf. Where we act on behalf of the insurer and not you, we will notify you accordingly and in relation to claims we will advise you of this fact when you notify us of a claim. Notwithstanding this, we endeavour to always act in your best interest. As intermediaries, we offer a wide range of insurance products and have access to many leading insurance companies and the Lloyd’s market. Depending on the type of cover you require and where we have provided advice based on a personal recommendation, we will offer you a policy from either: • a single insurer; • a limited range of insurers; or • a fair analysis that is representative of the insurance market. We will advise you separately as to which of these apply before we arrange your policy and where we have not undertaken a fair analysis of the market, we will provide you with a list of insurers considered. Jensten Retail Consumer Client TOBA Version 1.0 Nov 2021 Policies taken out, amended, or renewed through our online service will be on a non-advised basis. This means sufficient information will be provided for you to make an informed decision about any product purchased online and you should therefore ensure that any policy provides the cover you require and is suitable for your needs. For Motor Vehicle insurance we require customers to pay an additional charge for our claims service – Coversure Claimsline (details are provided in a separate document). This is a “one-stop” service that enables us to assist you with any claim you may incur. The cost of the Coversure Claimsline services will be included in the price quoted to you for the Motor Vehicle insurance and shown separately in your documentation. By purchasing motor insurance from us, you authorise Coversure and its agents to take all necessary actions to handle your claim including dealing with your insurers, third parties and their insurers and other service suppliers on your behalf. For all other policies, including optional additional products and premium finance (if relevant), before the insurance contract is concluded and after we have assessed your demands & needs, we will provide you with advice and make a personal recommendation. This will include sufficient information to enable you to make an informed decision about the policy that we have recommended, together with a quotation which will itemise any fees that are payable in addition to the premium. This documentation will also include a statement of your demands and needs. You should read this carefully as it will explain reasons for making the recommendation we have made.

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia.

  • Telemedicine Services This plan covers clinically appropriate telemedicine services when the service is provided via remote access through an on-line service or other interactive audio and video telecommunications system in accordance with R.I. General Law § 27-81-1. Clinically appropriate telemedicine services may be obtained from a network provider, and from our designated telemedicine service provider. When you seek telemedicine services from our designated telemedicine service provider, the amount you pay is listed in the Summary of Medical Benefits. When you receive a covered healthcare service from a network provider via remote access, the amount you pay depends on the covered healthcare service you receive, as indicated in the Summary of Medical Benefits. For information about telemedicine services, our designated telemedicine service provider, and how to access telemedicine services, please visit our website or contact our Customer Service Department.

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