Delegated Credentialing Sample Clauses

Delegated Credentialing. Contractor may subcontract or delegate all or part of its credentialing functions when the subcontractor or delegate, such as a Provider organization, maintains a formal credentialing program in compliance with Contractor, NCQA, the Department and applicable regulatory agency standards. Contractor shall remain responsible for Provider credentialing and re-credentialing.
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Delegated Credentialing. The FIDA Plan may subcontract or delegate all or part of its credentialing functions when the First Tier or Downstream Entity, such as a Participating Provider organization, maintains a formal credentialing program in compliance with the FIDA Plan, NCQA, CMS, NYSDOH and applicable regulatory standards. The FIDA Plan shall remain responsible for delegated Participating Provider credentialing and re-credentialing.
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Delegated Credentialing. The contract between the Department and the MCOs permits the plan to delegate credentialing of individual providers to a facility. However, the MCO is ultimately responsible and accountable to DSS for compliance with the Department's credentialing requirements. For the purpose of HUSKY, delegated credentialing means that the MCO entrusts the Department's credentialing requirements to another entity. MCOs delegate credentialing to a variety of entities depending on the nature of the services and the type of provider. In delegated credentialing, the MCO remains responsible to DSS to verify and monitor compliance with the Department's credentialing requirements. The Department views delegated credentialing as a form of subcontract, therefore, similar oversight issues arise in the performance of the credentialing requirements. The Department requires the plans to demonstrate and document to DSS the plan's strong oversight of its delegated credentialing facilities. (Part II, Section 3.41 in B 3.44 in A, Subcontracting for Services).
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Delegated Credentialing. ReCredentialing. Anthem BC&BS reserves the right to require CONTRACTING PROVIDER to conduct Credentialing and/or ReCredentialing upon ninety (90) days prior written notice to CONTRACTING PROVIDER. CONTRACTING PROVIDER shall perform any such Credentialing and ReCredentialing in compliance with Anthem BC&BS requirements and otherwise in accordance with accreditation standards related thereto of the National Committee for Quality Assurance ("NCQA").
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Delegated Credentialing. The Contractor will ensure the qualifications of all network practitioners, approve new providers and sites, and terminate or suspend individual providers. The Contractor may delegate Credentialing and recredentialing activities but will monitor the completion and effectiveness of the delegated process, If the Contractor delegates Credentialing and recredentialing activities, the Contractor will implement and maintain policies and procedures which delineate the delegated activities and responsibility for these activities.
Sample 1
Delegated Credentialing. For contractors who delegate credentialing, the credentialing subcontractor must meet the requirements of Paragraphs 2.12.4.1 and 2.12.4.2 of this contract. The contractors Credentialing Committee must review and approve or disapprove providers submitted by the delegated credentialing provider. The contractor will monitor the delegated credentialing provider at least annually to ensure compliance with Paragraphs 2.12.4.1 and 2.12.4.2. (1) Provide for prompt submission of information needed to make payment. (2) Make full disclosure of the method and amount of compensation or other consideration to be received from the contractor. The provider must not charge for any service provided to the recipient at a rate in excess of the rates established by the contract in accordance with Section 1128B(d)(1), Social Security Act (enacted by Section 4704 of the Balanced Budget Act of 1997). The provider may not xxxx the recipient any amount greater than would be owed if the entity provided the services directly. (3) Require an adequate record system be maintained for recording services, charges, dates and all other commonly accepted information elements for services rendered to recipients.
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Delegated Credentialing. Contractor may subcontract all or part of its credentialing functions when the subcontractor, such as a Provider organization, maintains a formal credentialing program in compliance with Contractor, NCQA, the Department, and applicable regulatory agency standards. Contractor shall remain responsible for Provider credentialing and re-credentialing. Verification of qualifications of Providers of Covered Services under HCBS Waivers. Contractor shall ensure that only those Providers that are approved and authorized by the Department are providing Covered Services under HCBS Waivers, and that those Providers are providing to Enrollees only Covered Services for which they are approved and authorized. The Department will provide Contractor with a weekly Department extract file containing the list of such approved and authorized Providers. Contractor is not required to credential Providers of Covered Services under HCBS Waivers.‌ Department Credentials Verification Organization (CVO). The Department may require Contractor to delegate credentialing services to a CVO identified by the Department. The Department shall provide at least ninety (90) days’ notice, in writing, of this change. The Department retains the right to define the scope of services required to be provided by such a CVO.
Sample 1
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Delegated Credentialing. (1) For Contractors who delegate credentialing, the credentialing subcontractor must meet the requirements of this ATTACHMENT I, sections 2.12.4.1 and 2.12.4.2. (2) The Contractors Credentialing Committee must review and approve or disapprove providers submitted by the delegated credentialing provider. (3) The Contractor shall monitor the delegated credentialing provider at least annually to ensure compliance with this ATTACHMENT I, sections 2.12.4.1 and 2.12.4.2.
Sample 1
Delegated Credentialing. Contractor may delegate Credentialing and recredentialing activities but shall monitor the completion and effectiveness of the delegated process. If Contractor delegates Credentialing and recredentialing activities, Contractor shall implement and maintain policies and procedures which delineate the delegated activities and responsibility for these activities.
Sample 1

Related to Delegated Credentialing

  • Delegation; Committees The Trustees shall have the power, consistent with their continuing exclusive authority over the management of the Trust and the Trust Property, to delegate from time to time to such of their number or to officers, employees or agents of the Trust the doing of such things, including any matters set forth in this Declaration, and the execution of such instruments either in the name of the Trust or the names of the Trustees or otherwise as the Trustees may deem expedient. The Trustees may designate one or more committees which shall have all or such lesser portion of the authority of the entire Board of Trustees as the Trustees shall determine from time to time except to the extent action by the entire Board of Trustees or particular Trustees is required by the 0000 Xxx.

  • Joint Remediation Committee If the Sellers (acting reasonably) determine that the Purchasers have committed a Major Default, then, at the election of the Sellers, within three (3) Business Days of the Sellers providing the Purchasers written notice of such determination, the Sellers and the Purchasers shall establish a joint remediation committee of designated executives from the Sellers and the Purchasers (“Joint Remediation Committee”) consisting of three (3) members of each of the Sellers and the Purchasers. The Joint Remediation Committee shall be responsible for overseeing the development of a mutually agreeable plan in accordance with subsection 3 below to either (i) remediate any breaches giving rise to the Major Default to the extent such breaches can be remediated and/or (ii) prevent similar breaches from recurring in the future (clauses (i) and (ii), a “Corrective Action Plan”). Each member of the Joint Remediation Committee shall have sufficient authority on the part of his or her respective party to make decisions relating to matters reviewed by the Joint Remediation Committee, and shall be approved by the other party (such approval not to be unreasonably delayed, conditioned or withheld). The Joint Remediation Committee shall have access to Purchaser Personnel that are primarily responsible for the area of the business relationship (such as information technology, data security or regulatory) where the breaches giving rise to the Major Default arise (such Purchaser Personnel, collectively, the “Subject Matter Experts”). The Sellers and the Purchasers shall cause their respective members on the Joint Remediation Committee to, and the Purchasers shall cause the Subject Matter Experts to, act in good faith in connection with the development of the Corrective Action Plan.

  • Nurse Representatives & Grievance Committee (a) The Hospital agrees to recognize Association representatives to be elected or appointed from amongst nurses in the bargaining unit for the purpose of dealing with Association business as provided in this Collective Agreement. The number of representatives and the areas which they represent are set out in the Appendix of Local Provisions. (b) The Hospital will recognize a Grievance Committee, one of whom shall be chair. This committee shall operate and conduct itself in accordance with the provisions of the Collective Agreement and the number of nurses on the Grievance Committee is set out in the Appendix of Local Provisions. (c) It is agreed that Union representatives and members of the Grievance Committee have their regular duties and responsibilities to perform for the Hospital and shall not leave their regular duties without first obtaining permission from their immediate supervisor. Such permission shall not be unreasonably withheld. If, in the performance of their duties, a union representative or member of the Grievance Committee is required to enter a unit within the hospital in which they are not ordinarily employed they shall, immediately upon entering such unit, report their presence to the supervisor or nurse in charge, as the case may be. When resuming their regular duties and responsibilities, such representatives shall again report to their immediate supervisor. The Hospital agrees to pay for all time spent during their regular hours by such representatives hereunder.

  • LABOR/MANAGEMENT COMMITTEES A. Statewide

  • COMPLIANCE COMMITTEE (1) Within thirty (30) days of the date of this Agreement, the Board shall appoint a Compliance Committee of at least three (3) directors, of which no more than one (1) shall be an employee or controlling shareholder of the Bank or any of its affiliates (as the term “affiliate” is defined in 12 U.S.C. § 371c(b)(1)), or a family member of any such person. Upon appointment, the names of the members of the Compliance Committee and, in the event of a change of the membership, the name of any new member shall be submitted in writing to the Assistant Deputy Comptroller. The Compliance Committee shall be responsible for monitoring and coordinating the Bank's adherence to the provisions of this Agreement. (2) The Compliance Committee shall meet at least monthly. (3) Within sixty (60) days of the date of this Agreement and quarterly thereafter, the Compliance Committee shall submit a written progress report to the Board setting forth in detail: (a) a description of the action needed to achieve full compliance with each Article of this Agreement; (b) actions taken to comply with each Article of this Agreement; and (c) the results and status of those actions. (4) The Board shall forward a copy of the Compliance Committee's report, with any additional comments by the Board, to the Assistant Deputy Comptroller within ten (10) days of receiving such report.

  • Contractor’s Project Manager and Key Personnel Contractor shall appoint a Project Manager to direct the Contractor’s efforts in fulfilling Contractor’s obligations under this Contract. This Project Manager shall be subject to approval by the County and shall not be changed without the written consent of the County’s Project Manager, which consent shall not be unreasonably withheld. The Contractor’s Project Manager shall be assigned to this project for the duration of the Contract and shall diligently pursue all work and services to meet the project time lines. The County’s Project Manager shall have the right to require the removal and replacement of the Contractor’s Project Manager from providing services to the County under this Contract. The County’s Project manager shall notify the Contractor in writing of such action. The Contractor shall accomplish the removal within five (5) business days after written notice by the County’s Project Manager. The County’s Project Manager shall review and approve the appointment of the replacement for the Contractor’s Project Manager. The County is not required to provide any additional information, reason or rationale in the event it The County is not required to provide any additional information, reason or rationale in the event it requires the removal of Contractor’s Project Manager from providing further services under the Contract.

  • Independence of Administrator For all purposes of this Agreement, the Administrator shall be an independent contractor and shall not be subject to the supervision of the Issuer or the Owner Trustee with respect to the manner in which it accomplishes the performance of its obligations hereunder. Unless expressly authorized by the Issuer, the Administrator shall have no authority to act for or represent the Issuer or the Owner Trustee in any way and shall not otherwise be deemed an agent of the Issuer or the Owner Trustee.

  • Scope of Delegated Responsibilities (a) SELECTION OF ELIGIBLE FOREIGN CUSTODIANS. Subject to the provisions of this Section 3.2, the Foreign Custody Manager may place and maintain the Foreign Assets in the care of the Eligible Foreign Custodian selected by the Foreign Custody Manager in each country listed on Schedule A, as amended from time to time. In performing its delegated responsibilities as Foreign Custody Manager to place or maintain Foreign Assets with an Eligible Foreign Custodian, the Foreign Custody Manager shall determine that the Foreign Assets will be subject to reasonable care, based on the standards applicable to custodians in the country in which the Foreign Assets will be held by that Eligible Foreign Custodian, after considering all factors relevant to the safekeeping of such assets, including, without limitation the factors specified in Rule 17f-5(c)(1).

  • Delegated Identity Theft Prevention Duties Terms in quotation marks in this Section shall have the meaning such terms are assigned in the Identity Theft Red Flag Rules under 16 CFR §681.2 issued by the Federal Trade Commission in November 2007, and replaced by 17 CFR Part 248 issued by the Securities and Exchange Commission on April 10, 2013 (in each case pursuant to the Fair and Accurate Credit Transactions Act of 2003 (the “FACT Act”)), as may be amended from time to time, and the implementing regulations (collectively, the “Rules”). In general, the term “Delegated Identity Theft Prevention Duties” encompasses the functions necessary to fulfill obligations that are imposed upon the Trust and the Fund by the Rules and that relate to information maintained or transactions processed by the Transfer Agent (collectively, the “Identity Theft Prevention Obligations”). Notwithstanding anything to the contrary herein or elsewhere, the Delegated Identity Theft Prevention Duties shall not include any identity theft prevention function related to an obligation of the Trust that is performed by any entity that is neither directly nor indirectly owned by FMR LLC (an “Unaffiliated Intermediary”) pursuant to a provision of a Selling Dealer Agreement, Bank Agency Agreement, or any other agreement between Fidelity Distributors Company LLC or any other entity directly or indirectly owned by FMR LLC and the Unaffiliated Intermediary. Where applicable, the Trust has appointed FIIOC to implement its written IDTPP, which is reasonably designed to comply with the Rules. The IDTPP includes the Delegated Identity Theft Prevention Duties and reflects the Fund’s practices for detecting, preventing and mitigating identity theft for covered accounts. Where applicable the Fund shall exercise appropriate oversight of FIIOC’s IDTPP activities through the Fund’s Program Officer (as that is defined in the IDTPP) or his/her delegates.

  • Delegated Duties 4.1 Consistent with the services provided by CFS and with respect to the applicable shareholder information maintained by CFS, CFS shall: i. Submit all new account and registration maintenance transactions through the Office of Foreign Assets Control (“OFAC”) database and such other lists or databases of trade restricted individuals or entities as may be required from time to time by applicable regulatory authorities; ii. Submit special payee checks through OFAC database; iii. Review redemption transactions that occur within thirty (30) days of account establishment or maintenance; iv. Review wires sent pursuant to instructions other than those already on file with CFS; v. Review accounts with small balances followed by large purchases; vi. Review accounts with frequent activity within a specified date range followed by a large redemption; vii. On a daily basis, review purchase and redemption activity per tax identification number (“TIN”) within each Fund to determine if activity for that TIN exceeded the $100,000 threshold on any given day; viii. Compare all new accounts and registration maintenance through the Known Offenders database and notify the Trust of any match. ix. Monitor and track cash equivalents under $10,000 for a rolling twelve-month period and file any required reports with the IRS and issue the Shareholder notices required by the IRS; x. Determine when a suspicious activity report (“SAR”) should be filed as required by regulations applicable to mutual funds and prepare and file the SAR. Provide the Trust with a copy of the SAR within a reasonable time after filing; notify the Trust if any further communication is received from U.S. Department of the Treasury or other law enforcement agencies regarding the SAR; xi. Compare account information to any FinCEN request received by the Trust and provided to CFS pursuant to USA PATRIOT Act Sec. 314(a). Provide the Trust with documents/information necessary to respond to requests under USA PATRIOT Act Sec. 314(a) within required time frames; (i) Verify the identity of any person seeking to open an account with each Fund, (ii) maintain records of the information used to verify the person’s identity in accordance with applicable regulations, (iii) determine whether the person appears on any lists of known or suspected terrorists or terrorist organizations provided to the Trust by any government agency, and (iv) perform enhanced due diligence with respect to any investor that CFS has reason to believe presents high risk factors with regard to money laundering or terrorist financing, prior to accepting an investment from such investor; and (i) Monitor for any suspected money laundering activity with respect to correspondent accounts for foreign financial institutions and private banking accounts and report any such conduct required by applicable regulations, and (ii) conduct due diligence on private banking accounts in the event that one or more Funds changes its line of business in a manner that would involve the establishment or maintenance of such accounts. 4.2 In the event that CFS detects activity as a result of the foregoing procedures, CFS shall timely file any required reports, promptly notify appropriate government agencies and also immediately notify the Fund, unless prohibited by applicable law.

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