ELIGIBILITY PROCESSING Sample Clauses

ELIGIBILITY PROCESSING. 2 A. Contracting Hospitals and Qualified Clinics shall electronically submit MSI applications and 3 refer MSI patients to the Application Processor in a timely manner. 4 B. Contracting Hospitals and Qualified Clinics shall refer patients who are potentially Medi-Cal 5 eligible to SSA in a timely manner. 6 C. As a condition of eligibility processing by the Application Processor, MSI applications, and any 7 required documentation, shall be received by the Application Processor no later than the end of the third 8 month following the month during which services were provided. Applications received after this 9 deadline shall be denied. 10 D. The Application Processor shall be solely responsible for determining whether a person meets 11 the eligibility criteria as set forth in this Agreement.
Sample 1
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ELIGIBILITY PROCESSING. The MCTD contracts for “Travel Navigator” services with an outside vendor to provide information and eligibility services for all of its Mobility Management programs. Beginning in January 2016 the Travel Navigator contract will include eligibility processing for all Marin Access Paratransit Services. The monthly cost of Marin Access Eligibility Processing will be split between the MCTD and the GGBHTD based upon the percentage of passengers for each program (Intra-County and Inter-County).
Sample 1
ELIGIBILITY PROCESSING. 28 A. HOSPITAL shall deliver MSI applications and refer MSI Pending(s) to the Application 29 Processor in a timely manner. 30 B. HOSPITAL shall refer patients who are potentially Medi-Cal eligible to SSA in a timely 32 C. As a condition of eligibility processing by the Application Processor, MSI applications, and any 33 other required documentation, shall be received by the Application Processor no later than the end of the 34 third month following the month during which services were provided. Applications received after this 35 deadline shall be denied. 36 D. The Application Processor shall be solely responsible for determining whether a person meets 37 the eligibility criteria as set forth in this Agreement. 1 E. Patients determined to be Eligible Persons by the Application Processor shall be eligible for a 2 twelve-month period, or as may be modified by the ADMINISTRATOR and updated in the MSI 3 Provider Manual; commencing the first day of the month in which MSI Program Services were first 4 rendered, 5 F. HOSPITAL shall use its best efforts to inform physicians, osteopaths, podiatrists, and dentists 6 on its medical staff that an applicant for MSI eligibility is or is not eligible. 7 G. Dual Payments - If HOSPITAL subsequently receives any Medi-Cal reimbursement for a 8 patient, all MSI payments received under this Agreement shall be repaid either to the Intermediary 9 within thirty (30) days after receipt of Medi-Cal payment or to the Third Party Recovery Group in 10 accordance with subparagraph VI.G.4 of Exhibit D to this Agreement. 11 H. COUNTY shall contract with the Intermediary to: 12 1. Collect all MSI eligibility data by direct on-line input provided by the Application
Sample 1
ELIGIBILITY PROCESSING. 27 A. Qualified Clinic shall deliver MSI applications and refer MSI Pending(s) to the Application 28 Processor in a timely manner. 29 B. Qualified Clinic shall refer patients who are potentially Medi-Cal eligible to SSA in a timely 30 manner. 31 C. As a condition of eligibility processing by the Application Processor, MSI applications, and any 32 other required documentation, shall be received by the Application Processor no later than the end of the 33 third month following the month during which services were provided. Applications received after this 34 deadline shall be denied. 35 D. The Application Processor shall be solely responsible for determining whether a person meets 36 the eligibility criteria as set forth in this Agreement. 37 E. Patients determined to be Eligible Persons by the Application Processor shall be eligible for a 1 twelve-month period, or as may be modified by the ADMINISTRATOR and updated in the MSI 2 Provider Manual; commencing the first day of the month in which MSI Program Services were first 3 rendered. 4 F. Qualified Clinic shall use its best efforts to inform physicians, osteopaths, podiatrists, and 5 dentists on its medical staff that an applicant for MSI eligibility is or is not eligible. 6 G. Dual Payments - If CLINIC subsequently receives any Medi-Cal reimbursement for a patient, all 7 MSI payments received under this Agreement shall be repaid to the Intermediary within thirty (30) 8 calendar days after receipt of Medi-Cal payment. 9 H. COUNTY shall contract with the Intermediary to: 10 1. Collect all MSI eligibility data by direct on-line input provided by the Application 11 Processor. 12 2. Print and distribute, daily, the “Notice of Action” forms as to the disposition of claims to 13 both patient and provider. 14 // 15 // 16 // 17 // 18 // 19 // 20 // 21 // 22 // 23 // 24 // 25 // 26 // 27 // 28 // 29 // 30 // 31 // 32 // 33 // 34 // 35 // 36 // 37 1 EXHIBIT D 2 TO AGREEMENT FOR PROVISION OF 3 CLINIC SERVICES FOR THE 4 MEDICAL SERVICES INITIATIVE PROGRAM 5 CLAIMS AND DISBURSEMENTS 6 SEPTEMBER 1, 2010 THROUGH FEBRUARY 29, 2012 7
Sample 1
ELIGIBILITY PROCESSING. Qualified Clinic shall deliver MSI applications and refer MSI Pending(s) to the Application 29 Processor in a timely manner.
Sample 1
ELIGIBILITY PROCESSING. Contracting Hospitals and Qualified Clinics shall electronically submit MSI applications and 5 refer MSI patients to the Application Processor in a timely manner. 6 //
Sample 1

Related to ELIGIBILITY PROCESSING

  • Claims Processing BCBSM will process Provider's Clean Claims submitted in accordance with this Agreement in a timely fashion.

  • Sub-processing 11.1 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 sub-processor which imposes the same obligations on the sub- processor as are imposed on the data importer under the Clauses. Where the sub-processor 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 sub-processor’s obligations under such agreement. 11.2 The prior written contract between the data importer and the sub-processor shall also provide for a third-party beneficiary clause as laid down in Clause 3 for cases where the data subject is not able to bring the claim for compensation referred to in paragraph 1 of Clause 6 against the data exporter or the data importer because they have factually disappeared or have ceased to exist in law or have become insolvent and no successor entity has assumed the entire legal obligations of the data exporter or data importer by contract or by operation of law. Such third-party liability of the sub-processor shall be limited to its own processing operations under the Clauses. 11.3 The provisions relating to data protection aspects for sub-processing of the contract referred to in paragraph 1 shall be governed by the law of the Member State in which the data exporter is established, namely ........................................ 11.4 The data exporter shall keep a list of sub-processing agreements concluded under the Clauses and notified by the data importer pursuant to Clause 5(j), which shall be updated at least once a year. The list shall be available to the data exporter’s data protection supervisory authority.

  • Eligibility Verification (a) HHSC will verify Medicaid eligibility for Dual Eligible Members by the fifth business day of the month following the receipt of the MA Dual SNP’s monthly enrollment file, in accordance with Section 3.02(b). (b) To verify Medicaid eligibility of an individual Member, HHSC agrees to provide the MA Dual SNP with real-time access to HHSC’s claims administrator’s Medicaid eligibility verification system.

  • 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.

  • Wire Transfer Eligibility Section 11.24

  • Health Spending Account (HSA Wellness Spending Account (WSA)/Registered Retirement Savings Plan (RRSP) utilization rates;

  • Health Spending Account contributions by the Executive will cease on the Effective Date. The Executive may submit claims against the balance accrued to the Effective Date, until the end of the calendar year in which the Effective Date occurs.

  • Student Eligibility The LEA and POSTSECONDARY INSTITUTION shall qualify and advise candidates for dual credit from the pool of eligible high school students. A candidate for dual credit is eligible for consideration for fall, spring, and summer semesters if he or she: a. is enrolled during the fall and spring in a LEA in one-half or more of the minimum course requirements approved by PED for public school students under its jurisdiction or by being in physical attendance at a bureau of Indian education-funded high school at least three documented contact hours per day pursuant to 25 CFR 39.211(c); b. obtains permission from the LEA representative (in consultation with the student’s individualized education program team, as needed), the student’s parent or guardian if the student is under 18 years old, and POSTSECONDARY INSTITUTION representative prior to enrolling in a dual credit course; and c. meets POSTSECONDARY INSTITUTION requirements to enroll as a dual credit student.

  • Employee Eligibility Verification The Contractor warrants that it fully complies with all Federal and State statutes and regulations regarding the employment of aliens and others and that all its employees performing work under this Contract meet the citizenship or alien status requirement set forth in Federal statutes and regulations. The Contractor shall obtain, from all employees performing work hereunder, all verification and other documentation of employment eligibility status required by Federal or State statutes and regulations including, but not limited to, the Immigration Reform and Control Act of 1986, 8 U.S.C. §1324 et seq., as they currently exist and as they may be hereafter amended. The Contractor shall retain all such documentation for all covered employees for the period prescribed by the law. The Contractor shall indemnify, defend with counsel approved in writing by County, and hold harmless, the County, its agents, officers, and employees from employer sanctions and any other liability which may be assessed against the Contractor or the County or both in connection with any alleged violation of any Federal or State statutes or regulations pertaining to the eligibility for employment of any persons performing work under this Contract.

  • Payment Processing Citizens may require any other information from Vendor that Citizens deems necessary to verify any compensation request placed under this Agreement and Vendor agrees that it will provide such information as reasonably requested by Citizens. Payment shall be due net thirty (30) calendar days of Citizens’ actual receipt of a complete and undisputed invoice. Where a submitted invoice is incomplete, such as not containing the information described in this Section, Citizens will return the incomplete invoice to Vendor for correction within thirty (30) calendar days of Citizens’ actual receipt of such invoice. Where Citizens reasonably disputes any part of a complete invoice, such as the amount of the compensation request, Citizens shall pay any undisputed portion of the invoiced amount within (30) calendar days of Citizens’ actual receipt of the complete invoice and will describe the basis for the disputed portion of the invoiced amount. Where Vendor disagrees with Citizens dispute of any invoice, the Parties shall seek to resolve the dispute in accordance with the Dispute Resolution Process further described in this Agreement. In no case shall Citizens be subject to late payment interest charges where Vendor has submitted an incomplete invoice or where Citizens has reasonably disputed an invoice. Where Vendor fails to submit an invoice within twelve (12) calendar months of the Services for which compensation is being requested, Vendor acknowledges and agrees that any payment due for such Services is forfeited by Vendor for its failure to timely submit an invoice.

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