Authorization and Referral System Sample Clauses

Authorization and Referral System. The Contractor shall have a referral system for Medicaid MHN Program members requiring specialty health care services. The Contractor shall provide monitoring and follow-up on care provided by other medical service providers for diagnosis and treatment, to include externally referred services. There must be written evidence of the communication of the patient results/information to the referring physician by the specialty health care provider or continued communication of patient information with the primary care provider.
Sample 1
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Authorization and Referral System. The Contractor shall have a referral system for members requiring specialty health care services. There must be written evidence of the communication of the patient results/information to the referring physician by the specialty provider or continued communication of patient information between the specialty provider and the PCP.
Sample 1Sample 2
Authorization and Referral System. The Contractor shall have a referral system for Medicaid MCO Members requiring specialty health care services. The Contractor must require written evidence of the communication of the Medicaid MCO Member’s results/information to the referring physician by the Specialty Provider or continued communication of the Medicaid MCO Member’s patient information between the Specialty provider and the PCP.
Sample 1

Related to Authorization and Referral System

  • Authorization and Application of Overtime (a) An employee who is required to work overtime shall be entitled to overtime compensation when:

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  • Education and Prevention 6.1 The policy will be discussed and put forward for adoption on site at a meeting of all workers.

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  • Function and Role (a) The Works Committee shall assist the Parties by promoting cooperative and effective communication with respect to matters related to the Works. The Works Committee shall interface with the Equipment Steering Committee as and when required.

  • Joint Network Implementation and Grooming Process Upon request of either Party, the Parties shall jointly develop an implementation and grooming process (the “Joint Grooming Process” or “Joint Process”) which may define and detail, inter alia:

  • Authorization, Etc This Agreement and the Notes have been duly authorized by all necessary corporate action on the part of the Company, and this Agreement constitutes, and upon execution and delivery thereof each Note will constitute, a legal, valid and binding obligation of the Company enforceable against the Company in accordance with its terms, except as such enforceability may be limited by (i) applicable bankruptcy, insolvency, reorganization, moratorium or other similar laws affecting the enforcement of creditors’ rights generally and (ii) general principles of equity (regardless of whether such enforceability is considered in a proceeding in equity or at law).

  • Authorization of Overtime (a) Overtime work shall be assigned and authorized only by appointing authorities or their designated representatives either verbally or in writing.

  • Authorization to Proceed A fully executed and approved authorization in the form of Attachment 6 to this Agreement, Authorization to Proceed (“ATP”) accompanied by an executed purchase order document issued by the Owner to the Project Consultant, authorizing the performance of specific professional services, authorizing commencement of a Phase as defined in Article 2.1 through Article 2.8, and stating the time for completion and the amount of fee authorized for such services.

  • ACCREDITATION AND STANDARDS The IOP hereby agrees to: (a) Be licensed to provide IOP services within the applicable jurisdiction in which it operates. (b) Be specifically accredited by and remain in compliance with standards issued for IOPs by TJC, CARF, CoA, or an accrediting organization approved by the Director, DHA. The contractor may submit (via the TRO, the TOPO, or the COR for the USFHP) additional accrediting organizations for TRICARE authorization, subject to approval by the Director, DHA. (c) Accept the allowable IOP rate, as provided in 32 CFR 199.14(a)(2)(ix), as payment in full for services provided. (d) Comply with all requirements of 32 CFR 199.4 applicable to institutional providers generally concerning concurrent care review, claims processing, beneficiary liability, double coverage, utilization and quality review, and other matters. (e) Ensure that all mental health services are provided by qualified mental health providers who meet the requirements for individual professional providers. (Exception: IOPs that employ individuals with master’s or doctoral level degrees in a mental health discipline who do not meet the licensure, certification, and experience requirements for a qualified mental health provider but are actively working toward licensure or certification, may provide mental health services within the per diem rate but the individual must work under the direct clinical supervision of a fully qualified mental health provider employed by the IOP.) All other program services will be provided by trained, licensed staff. (f ) Not bill the beneficiary for services in excess of the cost-share or services for which payment is disallowed for failure to comply with requirements. (g) Not bill the beneficiary for services excluded on the basis of 32 CFR 199.4(g)(1) (not medically or psychologically necessary), (g)(3) (inappropriate level of care), or (g)(7) (custodial care), unless the beneficiary has agreed in writing to pay for the care, knowing the specific care in question has been determined as noncovered. (A general statement signed at admission as to financial liability does not fill this requirement.)

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