Denial of Payment for a Service Sample Clauses

Denial of Payment for a Service. The MCO must mail or hand deliver written notice of action xxxxx://xxx.xxx.xxxxxxxxx.xxx/familycare/mcos/noa.htm to an affected member when the MCO intends to deny a member’s request for payment of a service included in the benefit package. Although the MCO may pay for a service that is outside of the benefit package under the circumstances set forth in Article VII, Section A.5., an MCO is not required to provide a notice of action when it denies a member’s request for payment of such a service. The MCO is however required to inform members in writing when a request for payment of a service outside of the benefit package is denied. The MCO must utilize DHS’ Notification of Non Covered Benefit template (xxxxx://xxx.xxx.xxxxxxxxx.xxx/forms/f0/f01283.doc) and must maintain a copy of this completed form in the member’s file.
Sample 1
Denial of Payment for a Service. The IHCP must mail or hand deliver written notice of action xxxxx://xxx.xxx.xxxxxxxxx.xxx/familycare/mcos/noa.htm to an affected member when the IHCP intends to deny a member’s request for payment of a service included in the benefit package. Although the IHCP may pay for a service that is outside of the benefit package , an IHCP is not required to provide a notice of action when it denies a member’s request for payment of such a service. The IHCP is however required to inform members in writing when a request for payment of a service outside of the benefit package is denied. The IHCP must utilize DHS’ Notification of Non Covered Benefit template (xxxxx://xxx.xxx.xxxxxxxxx.xxx/forms/f0/f01283.doc) and must maintain a copy of this completed form in the member’s file.
Sample 1

Related to Denial of Payment for a Service

  • Payment for Overtime 1. Except as provided in 2.C.3., below, overtime shall be compensated at one and one-half (1 1/2) times the regular rate. 2. Except as provided in 2.C.3., below, for all regular, limited-term and probationary employees, overtime may be converted to compensatory time or paid for at the option of the agency/department. Consideration shall be given to effectuating the wishes of employees. The maximum number of CTO hours which may be accrued by any employee is eighty (80). If an employee accrues 80 hours of CTO, he/she cannot accrue additional CTO until he/she uses some of the hours in his/her bank; instead, employees will be paid for all overtime work performed in excess of that amount. 3. Overtime hours worked by extra help employees shall be paid. 4. Compensatory time earned and accrued by an employee in excess of thirty-two (32) hours may be scheduled off for an employee by his or her agency/department; however, consideration shall be given to effectuating the wishes of those employees requesting specific compensatory time off periods. 5. No scheduled compensatory time off will be cancelled except in cases of emergency. 6. In no case may an employee's work schedule be changed during the workweek when the purpose of such change is to avoid overtime compensation. 7. Time worked as overtime shall not be used to earn fringe benefits or to serve out probation or merit increase periods. Compensatory time off may be used as part of the established workweek to earn fringe benefits and to serve out probationary and merit increase periods. 8. An employee separating from the County service shall be paid for accumulated compensatory time in a lump sum payment.

  • Deferral of Payments The Executive shall have the right to elect to defer the Post-Change in Control Severance Payment to be received by the Executive pursuant to this Section 6 under the terms and conditions of the Deferred Compensation Plan. Any such deferral election shall be made in accordance with Section 18(b) hereof.

  • Payment for annual leave (a) Before going on annual leave, an employee will be paid the amount of wages they would have received for ordinary time worked had they not been on leave during that period. (b) At the election of the employee such payments may be paid in accordance with the usual pay day relevant to the period of leave being taken.

  • Payment for leave (a) Payment will be made based on the Employee’s ordinary pay for the ordinary hours the Employee would have worked on the day or days on which the leave was taken. (b) An Employee utilising personal leave may take leave for part of a single day. Leave will be deducted from the Employee’s accrued personal leave including, where relevant, for a part day.

  • Termination of Payment Fund Any portion of the Payment Fund that remains undistributed to the holders of Certificates and Book Entry Shares for twelve months after the Effective Time shall be delivered by the Paying Agent to the Parent, upon demand, and any holder of a Certificate or Book Entry Shares who has not theretofore complied with this Article II shall thereafter look only to the Parent for payment of the Merger Consideration, but shall have no greater rights against the Parent than may be accorded to general unsecured creditors of the Parent under applicable law.

  • PAYMENT FOR WORK The H-GAC Customer is responsible for making payment to the Contractor upon delivery and acceptance of the goods or completion of the services and submission of the subsequent invoice.

  • Payment for TIPS Sales TIPS Members may make payments for TIPS Sales directly to Vendor, Vendor’s Authorized Reseller, or as otherwise agreed to in the applicable Supplemental Agreement after receipt of the invoice and in compliance with applicable payment statutes. Regardless of how payment is issued or received for a TIPS Sale, Vendor is responsible for all reporting and TIPS Administration Fee payment requirements as stated herein.

  • Compensation and Method of Payment Subject to any limitations set forth below or elsewhere in this Agreement, District agrees to pay Consultant the amounts specified in Exhibit B “Compensation”. The total compensation, including reimbursement for actual expenses, shall not exceed Ninety-Two Thousand Dollars ($92,000.00), unless additional compensation is approved in writing by the District. a. Each month Consultant shall furnish to District an original invoice for all work performed and expenses incurred during the preceding month. The invoice shall detail charges by the following categories: labor (by sub-category), travel, materials, equipment, supplies, and sub-consultant contracts. Sub-consultant charges, if any, shall be detailed by the following categories: labor, travel, materials, equipment and supplies. District shall independently review each invoice submitted by the Consultant to determine whether the work performed and expenses incurred are in compliance with the provisions of this Agreement. In the event that no charges or expenses are disputed, the invoice shall be approved and paid according to the terms set forth in subsection b. In the event any charges or expenses are disputed by District, the original invoice shall be returned by District to Consultant for correction and resubmission. b. Except as to any charges for work performed or expenses incurred by Consultant which are disputed by District, District will use its best efforts to cause Consultant to be paid within forty-five (45) days of receipt of Consultant’s correct and undisputed invoice. c. Payment to Consultant for work performed pursuant to this Agreement shall not be deemed to waive any defects in work performed by Consultant.

  • Payment for Services Contractor shall exert reasonable and diligent efforts to collect prompt payment from the Commonwealth. Contractor shall pay Subcontractor in proportion to amounts received from the Commonwealth which are attributable to the Services performed by Subcontractor. Contractor shall pay Subcontractor within fourteen (14) days after the Contractor receives such payment from the Commonwealth, unless the parties expressly agree upon a different payment schedule or structure as set forth below: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________.

  • Confirmation of Payment The Administrative Agent and the Lenders will, upon request after payment of the Credit Party Obligations which are the subject of this Guaranty and termination of the Commitments relating thereto, confirm to the Borrower, the Guarantors or any other Person that such indebtedness and obligations have been paid and the Commitments relating thereto terminated, subject to the provisions of Section 10.2.