Continuity of Care from Plan Providers Sample Clauses

Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating an Insured, except for reasons of medical incompetence or professional misconduct as determined by SHL. Coverage provided under this section is available until the latest of the following dates:  The 120th day following the date the contract was terminated between the Provider and SHL; or  If the medical condition is Complication of Pregnancy, the 45th day after the date of delivery or if the pregnancy does not end in delivery the date of the end of the pregnancy. The Insured or Plan Provider may submit a request for continuity of care to the address shown below. If the Plan agrees to the continued treatment, the Plan will pay for Covered Services at the Plan Provider level of benefits for a limited time, as outlined above. The Plan Provider may not seek payment from the Insured for any amounts for which the Insured would not be responsible if the Provider were still a Plan Provider. Sierra Health and Life Insurance Co., Inc. Attn: Provider Services Department XX Xxx 00000 Xxx Xxxxx, XX 00000-0000 Phone: 000-000-0000
Sample 1Sample 2See All (11)
AutoNDA by SimpleDocs
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating a Member, except for reasons of medical incompetence or professional misconduct as determined by HPN. Coverage provided under this section is available until the latest of the following dates:  The 120th day following the date the contract was terminated between the Provider and HPN; or  If the medical condition is pregnancy, the 45th day after the date of delivery or if the pregnancy does not end in delivery the date of the end of the pregnancy. The Member or Plan Provider may submit a request for continuity of care to the address shown below. If the Plan agrees to the continued treatment, the Plan will pay for Covered Services at the Plan Provider level of benefits for a limited time, as outlined above. The Plan Provider may not seek payment from the Member for any amounts for which the Member would not be responsible if the Provider were still a Plan Provider. Health Plan of Nevada, Inc. Attn: Provider Services Department XX Xxx 00000 Xxx Xxxxx, XX 00000-0000 Phone: 0-000-000-0000
Sample 1See All (7)
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating a Member, except for reasons of medical incompetence or professional misconduct as determined by HPN. Coverage provided under this section is available until the latest of the following dates: • The 120th day following the date the contract was terminated between the Provider and HPN; or • If the medical condition is pregnancy, the 45th day after the date of delivery or if the pregnancy does not end in delivery the date of the end of the pregnancy. The Member or Plan Provider may submit a request for continuity of care to the address shown below. If the Plan agrees to the continued treatment, the Plan will pay for Covered Services at the Plan Provider level of benefits for a limited time, as outlined above. The Plan Provider may not seek payment from the Member for any amounts for which the Member would not be responsible if the Provider were still a Plan Provider. Health Plan of Nevada, Inc. Attn: Provider Services Department XX Xxx 00000 Xxx Xxxxx, XX 00000-0000 Phone: 0-000-000-0000
Sample 1See All (4)
Continuity of Care from Plan Providers. All decisions of SHL’s Managed Care Program may be appealed by the Insured or his Authorized Representative through the Appeals Procedures. If an imminent and serious threat to the health of the Insured exists, the appeal will be directed to SHL's Medical Director.
Sample 1
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating a Member, except for reasons of medical incompetence or professional misconduct as determined by HPN. Coverage provided under this section is available until the latest of the following dates:
Sample 1
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating a Member, except for reasons of medical incompetence or professional misconduct as determined by HPN. Coverage provided under this section is available until the latest of the following dates: • The 120th day following the date the contract was terminated between the Provider and HPN; or • If the medical condition is pregnancy, the 45th day after the date of delivery or if the pregnancy does not end in delivery the date of the end of the pregnancy. The Member or Plan Provider may submit a request for continuity of care to the address shown below. If the Plan agrees to the continued 0-000-000-0000 (English) 0-000-000-0000 (Español)
Sample 1
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating an Insured, except for reasons of medical incompetence or professional misconduct as determined by SHL. Coverage provided under this section is available until the latest of the following dates: • The 120th day following the date the contract was terminated between the Provider and SHL; or
Sample 1
AutoNDA by SimpleDocs
Continuity of Care from Plan Providers.  Semiprivate (or multibed unit) room, including bed, board, and general nursing care.  Private room including bed, board, and general nursing care, but only when treatment of the Member's condition requires a private room. The semiprivate room rate will be allowed toward the private room rate when a Member receives private room accommodations for any reason other than Medical Necessity.  Inpatient accommodations provided in connection with the birth of a child shall be provided for a minimum of forty-eight (48) hours following an uncomplicated vaginal delivery or a minimum of ninety-six (96) hours following an uncomplicated delivery by cesarean section. This provision does not require a Member to deliver in a Hospital or other healthcare facility or to remain therein for the minimum number of hours following delivery.  Intensive care unit (including Cardiac Care Unit), including bed, board, general and special nursing care, and ICU equipment.  Observation unit, including bed, board, and general nursing care not to exceed twenty-three (23) hours.  Nursery charges for newborns. Reimbursement for Covered Services provided by a Non-Plan Provider outside HPN’s Service Area to a newborn natural child or adopted child is limited to HPN’s Eligible Medical Expense for similar Covered Services provided in HPN's Service Area. Services and Supplies. Covered Services and supplies provided by a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, or Hospice Care Facility include:  operating, recovery, and treatment rooms and equipment (Hospital and Ambulatory Surgical Facility only);  delivery and labor rooms and equipment (Hospital and Ambulatory Surgical Facility only);  anesthesia materials and anesthesia administration by Hospital staff (Hospital and Ambulatory Surgical Facility only);  clinical pathology and laboratory services and supplies;  services and supplies for diagnostic tests required to diagnose Member's Illness, Injury or other conditions but only when charges for the services and/or supplies are made by the facility (Hospital, Skilled Nursing Facility and Ambulatory Surgical Facility only);  drugs consumed at the time and place dispensed which have been approved for general marketing in the United States by the Food and Drug Administration (FDA);  dressings, splints, casts and other supplies for medical treatment provided by the Hospital from a central sterile supply department;  oxygen and its administration;  non-replaced b...
Sample 1

Related to Continuity of Care from Plan Providers

  • Contractor Certification regarding Business with Certain Countries and Organizations Pursuant to Subchapter F, Chapter 2252, Texas Government Code, Contractor certifies Contractor is not engaged in business with Iran, Sudan, or a foreign terrorist organization. Contractor acknowledges this Agreement may be terminated and payment withheld if this certification is inaccurate.

  • Information and Services Required of the Owner § 4.1.1 The Owner shall provide information with reasonable promptness, regarding requirements for and limitations on the Project, including a written program which shall set forth the Owner’s objectives, constraints, and criteria, including schedule, space requirements and relationships, flexibility and expandability, special equipment, systems, sustainability and site requirements.

  • Selection of Subcontractors, Procurement of Materials and Leasing of Equipment The contractor shall not discriminate on the grounds of race, color, religion, sex, national origin, age or disability in the selection and retention of subcontractors, including procurement of materials and leases of equipment. The contractor shall take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract.

  • Standard of Care; Performance of Employees Consultant shall perform all Services under this Agreement in a skillful and competent manner, consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Consultant represents and maintains that it is skilled in the professional calling necessary to perform the Services. Consultant agrees that all employees and subconsultants shall have sufficient skill and experience to perform the Services assigned to them. Finally, Consultant represents that it, its employees and subconsultants shall have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Services, including a City Business License, and that such licenses and approvals shall be maintained throughout the Term of this Agreement. As provided for in the indemnification provisions of this Agreement, Consultant shall perform, at its own cost and expense and without reimbursement from the City, any services necessary to correct errors or omissions which are caused by the Consultant’s failure to comply with the standard of care provided for herein. Any employee of the Consultant or its sub-consultants who is determined by the City to be uncooperative, incompetent, a threat to the adequate or timely completion of the Project, a threat to the safety of persons or property, or any employee who fails or refuses to perform the Services in a manner acceptable to the City, shall be promptly removed from the Project by the Consultant and shall not be re-employed to perform any of the Services or to work on the Project.

  • VOLUNTEERS AND STUDENT WORKERS The Employer will utilize volunteers and student workers only to the extent they supplement and do not supplant bargaining unit employees. Volunteers and student workers will not supervise bargaining unit employees.

  • Education of Students with Disabilities 3.5.1. The DOE is the State of Hawaii's “state education agency” (SEA) and “local education agency” (LEA) for purposes of compliance with the Individuals with Disabilities Education Act (IDEA). All public schools, including charter schools, are part of and fall under the LEA. As such, the School shall comply with all applicable federal and State laws, rules, policies, procedures, and directives regarding the education of students with disabilities, including but not limited to Ch. 8-60, Hawaii Administrative Rules (HAR).

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!