Case-by-Case Added Services Clause Samples
The "Case-by-Case Added Services" clause defines how additional services outside the original contract scope can be requested and provided on an individual basis. Typically, this clause outlines the process for either party to propose extra work, such as specialized consulting or one-time tasks, and may require mutual agreement on terms, pricing, and timelines before proceeding. Its core function is to provide a structured mechanism for handling unforeseen or ad hoc service needs during the contract period, ensuring both parties have clarity and flexibility without needing to renegotiate the entire agreement.
Case-by-Case Added Services. Except as provided below, the HMO may offer additional benefits that are outside the scope of services to individual Members on a case-by-case basis, based on Medical Necessity, cost-effectiveness, the wishes of the Member/Member’s family, the potential for improved health status of the Member, and for STAR+PLUS Members based on functional necessity.
Case-by-Case Added Services. Except as provided below, the MCO may offer additional benefits that are outside the scope of services to individual Members on a case-by-case basis. Case-by-case services may be based on Medical Necessity, cost-effectiveness, the wishes of the Member/Member’s family, the potential for improved health status of the Member, and for STAR+PLUS Members based on Functional Necessity.
Section 8.1. 2.2, “Case-by-Case Added Services,” does not apply to the CHIP Perinate Members (unborn children).
Case-by-Case Added Services. Except as provided below, the MCO may offer additional benefits that are outside the scope of services to individual Members on a case-by-case basis. Case-by-case services may be based on Medical Necessity, cost-effectiveness, the wishes of the Member/Member’s family, the potential for improved health status of the Member, and for STAR+PLUS Members based on Functional Necessity.