CARE MANAGEMENT/ COORDINATION OF CARE Clause Samples

The CARE MANAGEMENT/COORDINATION OF CARE clause establishes the responsibilities and processes for overseeing and organizing a patient's healthcare services across different providers and settings. It typically outlines how information will be shared among care teams, assigns a primary coordinator, and may specify protocols for referrals or follow-up care. This clause ensures that patient care is seamless, reduces duplication of services, and addresses gaps in treatment, ultimately improving health outcomes and patient satisfaction.
CARE MANAGEMENT/ COORDINATION OF CARE a. The LME/PIHP shall ensure the coordination of care with each Enrollee’s primary care provider and any behavioral health provider enrolled to provide care for each Enrollee. LME/PIHP shall coordinate the discharge of Enrollees with Contractor to ensure that appropriate services have been arranged following discharge and to link Enrollee with other providers or community assistance. b. The LME/PIHP shall provide follow up activities to high risk Enrollees discharged from twenty-four hour care. c. If an Enrollee requires medically necessary MH/DD/SA services, the LME/PIHP shall arrange for Medicaid-reimbursable services for the Enrollee.
View SourceView Similar (4)
CARE MANAGEMENT/ COORDINATION OF CARE. 3.6.1. Sandhills Center shall ensure the coordination of care with each Member’s primary care Practitioner and any behavioral health Practitioner enrolled to provide care for each Member. Sandhills Center shall coordinate the discharge of Members with Practitioner to ensure that appropriate services have been arranged following discharge and to link Member with other Practitioners or community assistance. 3.6.2. Sandhills Center shall provide coordination of care to high-risk Members discharged from twenty-four-hour care. 3.6.3. If a Member requires medically necessary MH/DD/SA services, Sandhills Center shall arrange for Medicaid-reimbursable services for the Member when possible.
View SourceView Similar (2)
CARE MANAGEMENT/ COORDINATION OF CARE a. Where services are provided by other entities, the LME/PIHP shall ensure the coordination of care with each Enrollees’ primary care provider and any behavioral health provider enrolled to provide care for each Enrollee. LME/PIHP shall coordinate the discharge of Enrollees with LIP to ensure that appropriate services have been arranged following discharge and to link Enrollee with other providers or community assistance. The LIP will make best efforts to collaborate with LME/PIHP Care Management/Care Coordination, primary care physicians and other services providers. b. If an Enrollee requires medically necessary MH/DD/SA services, the LME/PIHP shall arrange for Medicaid-reimbursable services for the Enrollee.
View SourceView Similar (2)
CARE MANAGEMENT/ COORDINATION OF CARE. The LME/PIHP shall ensure the coordination of care with each Enrollee’s primary care provider and any behavioral health provider enrolled to provide care for each Enrollee. LME/PIHP shall coordinate the discharge of Enrollees with CONTRACTOR to ensure that appropriate services have been arranged following discharge and to link Enrollee with other providers or community assistance.
View Source
CARE MANAGEMENT/ COORDINATION OF CARE a. The LME/PIHP shall ensure the coordination of care with each Enrollee’s primary care provider and any behavioral health provider enrolled to provide care for each Enrollee. LME/PIHP shall coordinate the discharge of Enrollees with Contractor to ensure that appropriate services have been arranged following discharge and to link Enrollee with other providers or community assistance. b. The LME/PIHP shall provide coordination of care to high risk Enrollees discharged from twenty-four hour care as set forth in LME/PIHP’s contracts with the Department. c. If an Enrollee requires medically necessary MH/DD/SA services, the LME/PIHP shall arrange for Medicaid-reimbursable services for the Enrollee when possible.
View Source
CARE MANAGEMENT/ COORDINATION OF CARE. A. The BH I/DD Tailored Plan shall ensure the coordination of care with each Member’s primary care provider and any behavioral health provider enrolled to provide care for each Member. The BH I/DD Tailored Plan shall coordinate the discharge of Members with Contractor to ensure that appropriate services have been arranged following discharge and to link Members with other providers or community assistance. B. The BH I/DD Tailored Plan shall provide coordination of care to high risk Members discharged from twenty-four hour care as set forth in BH I/DD Tailored Plan’s contracts with the Department. C. If a Member requires medically necessary MH/IDD/SA services, the BH I/DD Tailored Plan shall arrange for Medicaid reimbursable services for the Member when possible.
View Source

Related to CARE MANAGEMENT/ COORDINATION OF CARE

  • Project Management and Coordination The Engineer shall coordinate all subconsultant activity to include quality of and consistency of work and administration of the invoices and monthly progress reports. The Engineer shall coordinate with necessary local entities.

  • Cooperation and Coordination The Parties acknowledge and agree that it is their mutual objective and intent to minimize, to the extent feasible and legal, taxes payable with respect to their collaborative efforts under this Agreement and that they shall use all commercially reasonable efforts to cooperate and coordinate with each other to achieve such objective.

  • Care Coordination Care coordination is defined as the organized delivery of member care activities between two (2) or more participants (including the member) involved in a member’s care to facilitate the appropriate delivery of health care services. Organizing care involves the marshaling of personnel and other resources needed to carry out all medically necessary member care activities and is often managed by the exchange of information among participants responsible for different aspects of care.

  • OVERSIGHT SERVICES Oversight services for the Fund provided by Price Associates shall include all oversight of BNY Mellon, Delegates and service providers that provide accounting, administrative, and tax support services and not specifically provided for under each Fund’s Investment Management Agreement. Price Associates provides all accounting, administrative, tax and oversight services to the Funds listed on Exhibit A2, including the below. Accounting Services provided by Price Associates shall include, among other things: · oversight of quality control, including processing results related to fund accounting services provided by Delegates or other third party service providers relating to pricing. Such oversight includes, but is not limited to, review of (a) NAV calculations and fund valuations, (b) securities pricing and resolution of pricing exceptions, and (c) calculation and preparation of any financial information or schedules; · end-of-day INAV oversight for ETFs that provide INAV · determining accounting and valuation policies, instructing Delegates and/or other service providers, and/or providing it with such advice that may be reasonably necessary, to properly account for all financial transactions and to maintain the Fund’s accounting procedures and records so as to ensure compliance with generally accepted accounting principles and tax practices and rules; and · calculating and authorizing expense accruals and payments; annual fund expense budgets; accrual analysis; rollforward calculations; payment of expenses; fees for payment to service providers; · facilitating on behalf of the Fund resolution and remediation of fund accounting issues escalated by Delegates and/or other service providers; · preparing daily NAV calculations, including all necessary component services such as valuation and particularly private company investment valuation, corporate actions processing, trade processing, and performing month-end and fiscal-period-end close processes; · recordkeeping as required; and · such other accounting services as agreed to by the parties not otherwise performed by Price Associates under the Investment Management Agreement. Administrative Services provided by Price Associates shall include, among other things: · ensuring maintenance for the Fund of all records that may be reasonably required in connection with the audit performed by the Fund’s independent registered public accountants, or by the Securities and Exchange Commission (“SEC”), the Internal Revenue Service (“IRS”) or such other Federal or state regulatory agencies; · cooperating with the Fund’s independent registered public accountants and taking all reasonable action in the performance of its obligations under the Agreement to assure that the necessary information is made available to such accountants for the expression of their opinion without any qualification as to the scope of their examination including, but not limited to, their opinion included in the Fund’s annual report on Form N-CSR and annual amendment to Form N-1A; · implementing and maintaining the systems, data storage and reporting necessary to perform services outlined herein; · all efforts concerning financial reporting services, including shareholder reports and financial information in regulatory filings; N-PORT and N-CEN; and other financial reporting services as necessary; · determining financial reporting policies, maintaining adequate controls over financial reporting to provide complete and accurate financial information and disclosures that are certified by officers of the Funds. Providing sub-certifications, as requested by officers of the Funds, for the adequacy of such controls and the completeness and accuracy of information included in Form N-CSR or any other form that may require certification; · periodic testing of Internal Revenue Code qualification requirements; · prepare and furnish fund performance information; · prepare and disseminate vendor survey information; · prepare and file Rule 24f-2 notices and payment; and · such other administrative services as agreed to by the parties, not otherwise performed by Price Associates under the Investment Management Agreement.

  • Project Management Services Contractor shall provide business analysis and project management services necessary to ensure technical projects successfully meet the objectives for which they were undertaken. Following are characteristics of this Service: