Cost Containment Features Sample Clauses

Cost Containment Features. This Plan contains at least the following cost containment provisions:  Preventive healthcare benefits.  HPN’s Managed Care Program.  Benefit limitations on certain services.  Member Copayments.
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Cost Containment Features. The AOC contains a number of cost containment provisions including, but not limited to: (a) Second and Third Opinions/Consultations; (b) Preventive healthcare benefits; (c) Plan Provider benefit incentives as described in Attachment A Benefit schedule; and (d) SHL’s Managed Care Program.
Cost Containment Features. HPN has the right to collect payments for healthcare services made in error. Hospitals, Physicians, other Providers, and/or the Subscriber have the responsibility to return any overpayments or incorrect payments to HPN. HPN has the right to offset any overpayment against any future payments. This Plan contains at least the following cost containment provisions: (a) Preventive healthcare benefits. (b) HPN’s Managed Care Program. (c) Benefit limitations on certain services. (d) Member Copayments. Each Member authorizes the Physician, Hospital, Skilled Nursing Facility or any other Provider of healthcare to permit the examination and copying of the Member's medical records, as requested by HPN. Information from medical records and information received from Physicians or Hospitals incident to the Physician/Patient relationship or Hospital/Patient relationship shall be kept confidential and except for use in connection with government requirements established by law or the administration of this Plan, records may not be disclosed to any unrelated third party without the Member’s consent.
Cost Containment Features. HPN may request additional information to determine whether to approve or deny the claim. HPN shall notify the Provider of its request for additional information within twenty (20) days after receipt of the claim. HPN will notify the Provider of the healthcare services of all the specific reasons for the delay in approving or denying the claim.
Cost Containment Features. If the laws of the jurisdiction of issue do not designate the maximum length of time in which such action may be brought, no action may be brought after three (3) years from the time within which proof of loss is required by the AOC.

Related to Cost Containment Features

  • Cost Containment The Benefit Fund Trustees are directed to explore all reasonable methods of cost containment to minimize the Employer contribution obligations under the contract. In the event Medicare becomes secondary in the application of the retiree benefit plan, the Trustees will take immediate and remedial action to protect the financial integrity of the Plan.

  • Cost Control The Construction Manager shall develop a system of cost control for the Work, including regular monitoring of actual costs for activities in progress and estimates for uncompleted tasks and proposed changes. The Construction Manager shall identify variances between actual and estimated costs and report the variances to the Owner and Architect, and shall provide this information in its monthly reports to the Owner and Architect, in accordance with Section 3.3.2.3 above.

  • Quality control system (i) The Contractor shall establish a quality control mechanism to ensure compliance with the provisions of this Agreement (the “Quality Assurance Plan” or “QAP”). (ii) The Contractor shall, within 30 (thirty) days of the Appointed Date, submit to the Authority’s Engineer its Quality Assurance Plan which shall include the following: (a) organisation, duties and responsibilities, procedures, inspections and documentation; (b) quality control mechanism including sampling and testing of Materials, test frequencies, standards, acceptance criteria, testing facilities, reporting, recording and interpretation of test results, approvals, check list for site activities, and proforma for testing and calibration in accordance with the Specifications for Road and Bridge Works issued by MORTH, relevant IRC specifications and Good Industry Practice; and (c) internal quality audit system. The Authority’s Engineer shall convey its approval to the Contractor within a period of 21 (twenty-one) days of receipt of the QAP stating the modifications, if any, required, and the Contractor shall incorporate those in the QAP to the extent required for conforming with the provisions of this Clause 11.2. (iii) The Contractor shall procure all documents, apparatus and instruments, fuel, consumables, water, electricity, labour, Materials, samples, and qualified personnel as are necessary for examining and testing the Project Assets and workmanship in accordance with the Quality Assurance Plan. (iv) The cost of testing of Construction, Materials and workmanship under this Article 11 shall be borne by the Contractor.

  • CERTIFICATION OF NO ASBESTOS CONTAINING MATERIALS OR WORK 8.1 The Contractor shall be responsible for ensuring that no asbestos containing materials or work is included within the scope of the Work. The Contractor shall take whatever measures it deems necessary to insure that all employees, suppliers, fabricators, material men, subcontractors, or their assigns, comply with this requirement. 8.2 The Contractor shall ensure that Texas Department of Health licensed individuals, consultants or companies are used for any required asbestos work including asbestos inspection, asbestos abatement plans/specifications, asbestos abatement, asbestos project management and third-party asbestos monitoring.

  • Configuration Management The Contractor shall maintain a configuration management program, which shall provide for the administrative and functional systems necessary for configuration identification, control, status accounting and reporting, to ensure configuration identity with the UCEU and associated cables produced by the Contractor. The Contractor shall maintain a Contractor approved Configuration Management Plan that complies with ANSI/EIA-649 2011. Notwithstanding ANSI/EIA-649 2011, the Contractor’s configuration management program shall comply with the VLS Configuration Management Plans, TL130-AD-PLN-010-VLS, and shall comply with the following:

  • Subprocessing The data importer shall not subcontract any of its processing operations performed on behalf of the data exporter under the Clauses without the prior written consent of the data exporter. Where the data importer subcontracts its obligations under the Clauses, with the consent of the data exporter, it shall do so only by way of a written agreement with the subprocessor which imposes the same obligations on the subprocessor as are imposed on the data importer under the Clauses. Where the subprocessor fails to fulfil its data protection obligations under such written agreement the data importer shall remain fully liable to the data exporter for the performance of the subprocessor's obligations under such agreement.

  • Monitoring System In each case in which the Custodian has exercised delegated authority to place Assets with a Foreign Custodian, the Custodian shall establish a system, to re-assess or re-evaluate selected Foreign Custodians, at least annually in accordance with Rule 17f-5(c)(3).

  • The Performance Improvement Process (a) The Performance Improvement Process will focus on the risks of non- performance and problem-solving. It may include one or more of the following actions: (1) a requirement that the HSP develop and implement an improvement plan that is acceptable to the LHIN; (2) the conduct of a Review; (3) a revision and amendment of the HSP’s obligations; and (4) an in-year, or year end, adjustment to the Funding, among other possible means of responding to the Performance Factor or improving performance. (b) Any performance improvement process begun under a prior service accountability agreement that was not completed under the prior agreement will continue under this Agreement. Any performance improvement required by a LHIN under a prior service accountability agreement will be deemed to be a requirement of this Agreement until fulfilled or waived by the LHIN.

  • Setup Parties mutually agree to meet and fulfill implementation requirements as specified and set forth as follows. To facilitate a fast and effective implementation, eLuma will be responsible for the following: 1. Assigning an implementation specialist who will lead the implementation project, ensure that eLuma and Partner tasks are completed in a timely manner, and make sure all parties are coordinated so that Services and Software access can begin as quickly as possible. 2. Assigning an information technology specialist who will assist with Site(s) configuration and setup in accordance with the Services and Software outlined in this Agreement. 3. Recruiting, hiring, onboarding and credentialing, training, and staffing the Partner needs as outlined in this Agreement. 4. Providing a copy of the fully executed Agreement, signed W-9, and the Professional and General Liability insurance to Partner upon request. 5. Training adult supervisors (also known as “Facilitators”) and creating a one-page document for each Site’s Facilitator including, but not limited to: 1. Logging into the eLuma’s software system. 2. Turning on the webcam, microphone, and audio. 3. Basic troubleshooting webcam, microphone, and audio issues. 4. How to contact the technical support team. 6. Creating the therapy schedule with the support of the Partner, or support the Partner in creating the therapy schedule. 7. Ordering and shipping Equipment upon the request of the Partner and invoicing in accordance with this Agreement. To facilitate a fast and effective implementation, Partner shall be responsible for the following before or during the implementation process with eLuma: 1. Assigning a main point of contact (“Implementation Champion”) for the Partner during implementation. The Implementation Champion will ensure that Partner tasks are completed in a timely manner and that the implementation stays on schedule. 2. Assigning an Information Technology specialist and providing a phone number and email in order to set up working computers, webcams, microphones, audio, and/or Ethernet connections at each Site used in conjunction with Services. 3. Providing caseload information including, but not limited to the number of Students requiring Services, minutes of Services, and group therapy session size. (Note: groups sessions are not to exceed four (4) Students at a time and no more than two (2) Students per computer.) 4. Providing the name(s) of each Site and Facilitator for each Site where Services will take place, along with each Facilitator’s best phone number and email address. 5. Providing access to Student Individualized Education Plans (“IEPs”) by software access, fax, or password protected pdf. 6. Providing current copies of the academic calendar, along with special scheduling considerations. 7. Providing support in creating the therapy schedule.

  • Signaling protocol The Parties will interconnect their networks using SS7 signaling where Technically Feasible and available as defined in GR 905 Telcordia Standards including ISDN User Part (ISUP) for trunk signaling and TCAP for CCS-based features in the Interconnection of their networks. All Network Operations Forum (NOF) adopted standards shall be adhered to. Where available, CenturyLink signaling services to link its Signaling Transfer Points (STPs) for CLEC switches which connect to CenturyLink’s STPs via “A” links or for CLEC’s STPs to connect to CenturyLink’s STPs via “D” links which are dedicated to the transport of signaling for local Interconnection, may be ordered from the CenturyLink Tariff.

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