Division of Financial Responsibility Sample Clauses

Division of Financial Responsibility. KEY M= Opt-Out to Medicare benefit for Hosptee Service Description Medical Group Hospital Incentive Program PacifiCare Diagnostic Tests - OP - Fac & Prof *** *** *** DME – IP *** *** *** DME, Ostomy Colostomy Supplies. Prosthetics. Orthotics – OP *** *** *** Emergency Room - OP – Fac *** *** *** Emergency Room - OP – E.R. Phys. *** *** *** Endoscopic Studies - IP – Prof *** *** *** Endoscopic Studies - OP – Fac *** *** *** Endoscopic Studies - OP – Prof *** *** *** Family Planning - Abortions - OP – Fac *** *** *** Family Planning - Abortions - OP – Prof *** *** *** Family Planning - Contraceptive Devices - Insertion - OP – Prof *** *** *** Family Planning - Contraceptive Devices - Non-Rx (eg. Norplant/IUD) - OP *** *** *** Family Planning - Contraceptive Devices - Prescription – OP *** *** *** Family Planning - GIFT ZIFT-IVF - OP - Fac & Prof *** *** *** Family Planning - Infertility Procedures - OP – Fac *** *** *** Family Planning - Infertility Procedures - OP – Prof *** *** *** Family Planning - Infertility Testing - OP – Prof *** *** *** Family Planning - Sterilization - IP & OP – Prof *** *** *** Family Planning - Sterilization - IP – Fac *** *** *** Family Planning - Sterilization - OP – Fac *** *** *** Fetal Monitoring - OP - Fac & Prof *** *** *** Health Education – OP *** *** *** Health Eval/Physical *** *** *** Hearing Aids/Molds – OP *** *** *** Hearing Screening (Audiologic Evaluation) – OP *** *** *** Hemodialysis / Dialysis - IP & OP – Prof *** *** *** Hemodialysis Dialysis - OP – Fac (including all drugs) *** *** *** Home Health Care / Homebound Infusion Therapy - OP – Prof *** *** *** Hosp Based Phys Interpretative Serv Incl Radiology & Pathology - IP & OP – Prof *** *** *** Hospice Services (Medicare) – IP – Fac & Prof – SH *** *** *** Hospice Services - Prof – CO *** *** *** Hospitalization Services - IP – Fac *** *** *** Immunizations & Inoculations (Medically Necessary) – OP *** *** *** Infusion therapy – OP *** *** *** Injectables - Not Part of Outpatient Pharmacy Benefits – OP *** *** *** Laboratory/Pathology (Diagnostic Only) - OP – Fac *** *** *** Laboratory/Pathology (Diagnostic Only) - OP – Prof *** *** *** Laboratory/Pathology - IP – Fac *** *** *** Lithotripsy - OP – Fac *** *** *** Lithotripsy - OP – Prof *** *** *** Med/Surg Supplies (casts, splints, bandages) - Office – OP *** *** *** Medication - Prescription – OP *** *** *** Mental Health (Crisis Intervention) - OP - Prof – CO *** *** *** MENTAL HEALTH: AB88 Benefits (Ment...
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Division of Financial Responsibility is the matrix for each Managed Care Plan which specifies the financial responsibility for Covered Services between PacifiCare, Medical Group and the Hospital Incentive Program. The Division of Financial Responsibility is an integral part of this Agreement.
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Division of Financial Responsibility. The Division of Financial Responsibility (DFR), attached to this Agreement as Exhibit 4, shall serve as the specific designation of financial risk for the Medical Group, Hospital Incentive Program and PacifiCare for Transplant Services (other than skin or ophthalmic transplants, which are addressed separately in the DFR):
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Division of Financial Responsibility. The following matrix outlines the division of financial responsibility between PacifiCare, Medical Group and Hospital, the intent being to clarify Covered Services categories in order to provide for accurate administration. The matrix serves as a model under which broad Covered Service categories suggest the appropriate financial responsibility for Covered Services not specifically listed. The applicable Subscriber Agreement and Evidence of Coverage should be consulted for an accurate and complete description of Covered Services and the Provider Manual for administrative clarification. Member benefit information should be verified prior to the provision of services.
Sample 1
Division of Financial Responsibility. (Secure Horizons) The following matrix outlines the division of financial responsibility between PacifiCare, Medical Group and Hospital, the intent being to clarify Covered Services categories in order to provide for accurate administration. The matrix serves as a model under which broad Covered Service categories suggest the appropriate financial responsibility for Covered Services not specifically listed. The Secure Horizons Member's Subscriber Agreement should be consulted for an accurate and complete description of Covered Services. The Division of Financial Responsibility for the PacifiCare Commercial Health Plan set forth in Product Attachment A shall also apply to the Secure Horizons Health Plan.
Sample 1
Division of Financial Responsibility is hereby deleted in its entirety and replaced with a new Division of Financial Responsibility matrix, attached hereto and incorporated herein by this reference.
Sample 1
Division of Financial Responsibility. KEY: M = Opt-out to Medicare benefit for Hospice Service Description Medical Group Hospital Incentive Program PacifiCare Vision Care Materials - Contact Lenses/Frames (non-cataract) - OP - CO *** *** *** Vision Care Materials - Contact Lenses/Frames (non-cataract) - OP - SH *** *** *** Notes:
Sample 1
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Division of Financial Responsibility. (DFR) is the matrix for each Managed Care Plan which specifies the financial responsibility for Covered Services between PacifiCare, Medical Group and the Hospital Incentive Program. Experimental services that are Covered Services per the definition above shall have the financial responsibility described in the DFR. The Division of Financial Responsibility is an integral part of this Agreement. *** Confidential Information omitted and filed separately with the Securities and Exchange Commission.
Sample 1

Related to Division of Financial Responsibility

  • Financial Responsibility A Controlled Affiliate shall be operated in a manner that provides reasonable financial assurance that it can fulfill all of its contractual obligations to its customers.

  • General Responsibilities Issuer hereby engages Distributor to act as exclusive distributor of the shares of each class of the Funds. The Funds subject to this Agreement as of the date hereof are identified on SCHEDULE A, which may be amended from time to time in accordance with Section 11 below. Sales of a Fund's shares shall be made only to investors residing in those states in which such Fund is registered. After effectiveness of each Fund’s registration statement, Distributor will hold itself available to receive, as agent for the Fund, and will receive by mail, telex, telephone, or such other method as may be agreed upon between Distributor and Issuer, orders for the purchase of Fund shares, and will accept or reject such orders on behalf of the Fund in accordance with the provisions of the applicable Fund’s prospectus. Distributor will be available to transmit orders, as promptly as possible after it accepts such orders, to the Fund’s transfer agent for processing at the shares’ net asset value next determined in accordance with the prospectuses.

  • Tax Responsibility The Fund shall be liable for all taxes (including Taxes, as defined below) relating to its investment activity, including with respect to any cash or securities held by the Custodian on behalf of the Fund or any transactions related thereto. Subject to compliance by the Fund with its obligations under Section 7.1, the Custodian shall withhold (or cause to be withheld) the amount of any Tax which is required to be withheld under applicable law in connection with the collection on behalf of the Fund pursuant to this Agreement of any dividend, interest income or other distribution with respect to any security and the proceeds or income from the sale or other transfer of any security held by the Custodian. If any Taxes become payable with respect to any prior payment made to the Fund by the Custodian or otherwise, the Custodian may apply any credit balance in the Fund’s deposit account to the extent necessary to satisfy such Tax obligation. The Fund shall remain liable for any tax deficiency. The Custodian is not liable for any tax obligations relating to the Portfolio or the Fund, other than those Tax services as set out specifically in this Section 7. The Fund agrees that the Custodian is not, and shall not be deemed to be, providing tax advice or tax counsel. The capitalized terms “Tax” or “Taxes” means any withholding or capital gains tax, stamp duty, levy, impost, charge, assessment, deduction or related liability, including any addition to tax, penalty or interest imposed on or in respect of (i) cash or securities, (ii) the transactions effected under this Agreement, or (iii) the Fund.

  • Legal Responsibility Nothing herein contained shall render any Party liable for the obligations of any other Party hereunder and the rights, obligations and liabilities of the Parties are several in accordance with their respective obligations, and not joint.

  • Additional Responsibilities The Sub-Advisor may, but shall not be under any duty to, perform services on behalf of the Fund which are not required by this Agreement upon the request of the Fund's Board of Directors. Such services will be performed on behalf of the Fund and the Sub-Advisor's charges in rendering such services will be billed monthly to the Fund, subject to examination by the Fund's independent certified public accountants. Payment or assumption by the Sub-Advisor of any Fund expense that the Sub-Advisor is not required to pay or assume under this Agreement shall not relieve the Sub-Advisor of any of its obligations to the Fund nor obligate the Sub-Advisor to pay or assume any similar Fund expenses on any subsequent occasions.

  • Custodial Responsibilities ARTICLE IX

  • Other Responsibilities The delivery of any notices to, and the obtaining of any consents from, any Permitted Transferee with respect to any provision of this Agreement, including, but not limited to, Sections 7.1 and 7.4, shall be your sole responsibility, unless otherwise agreed to in writing between such Permitted Transferee and the Sponsor. Neither the Company nor the Sponsor shall be liable to any Permitted Transferee for your failure to deliver a notice to, or obtain a consent from, any Permitted Transferee with respect to any provision of this Agreement, including, but not limited to, Sections 7.1 and 7.4.

  • REPORTING RESPONSIBILITY Any reporting responsibility of the Acquired Fund is and shall remain the responsibility of the Acquired Fund.

  • Limitation of Responsibility Notwithstanding any other provisions ---------------------------- hereof, Committee Members shall be liable to the parties only for actions constituting bad faith, gross negligence or breach of an express provision of this Agreement (so long as such breach remains uncured after ten (10) days of receiving notice of the nature of such breach). In all other respects, Committee Members shall not be liable for negligence or mistakes of judgment.

  • Joint Responsibility If the Seller determines that the Interface Problem is attributable partially to the design of a Warranted Part and partially to the design of any Supplier Part, the Seller will, if so requested by the Buyer, seek a solution to the Interface Problem through cooperative efforts of the Seller and any Supplier involved. The Seller will promptly advise the Buyer of such corrective action as may be proposed by the Seller and any such Supplier. Such proposal will be consistent with any then existing obligations of the Seller hereunder and of any such Supplier towards the Buyer. Such corrective action, unless reasonably rejected by the Buyer, will constitute full satisfaction of any claim the Buyer may have against either the Seller or any such Supplier with respect to such Interface Problem.

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