COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.
Clinical Management for Behavioral Health Services (CMBHS) System 1. request access to CMBHS via the CMBHS Helpline at (000) 000-0000. 2. use the CMBHS time frames specified by System Agency. 3. use System Agency-specified functionality of the CMBHS in its entirety. 4. submit all bills and reports to System Agency through the CMBHS, unless otherwise instructed.
Healthcare Section 1. Bargaining unit employees with one (1) year or more of service will be provided coverage for the duration of this contract through the “Full Coverage” Team Care Plan (“Team Care MM200”), which includes dental, vision, life, short term disability, medical and prescription drug benefits. Prior to January 1, 2020, bargaining unit employees with less than one (1) year of service will be provided coverage through the “Medical Only” plan. On January 1, 2020, all bargaining unit employees enrolled in the Medical Only plan shall be enrolled in the Full Coverage plan, and the Medical Only plan will eliminated. The rates for 2019 and a further description of the plan and rates are referenced
Home Health Care This plan covers the following home care services when provided by a certified home healthcare agency: • nursing services; • services of a home health aide; • visits from a social worker; • medical supplies; and • physical, occupational and speech therapy.
Health Services At the time of employment and subject to (b) above, full credit for registered professional nursing experience in a school program shall be given. Full credit for registered professional nursing experience may be given, subject to approval by the Human Resources Division. Non-degree nurses shall be placed on the BA Track of the Teachers Salary Schedule and shall be ineligible for movement to any other track.
Behavioral Health Services Behavioral health services include the evaluation, management, and treatment for a mental health or substance use disorder condition. For the purpose of this plan, substance use disorder does not include addiction to or abuse of tobacco and/or caffeine. Mental health or substance use disorders are those that are listed in the most updated volume of either: • the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association; or • the International Classification of Disease Manual (ICD) published by the World Health Organization. This plan provides parity in benefits for behavioral healthcare services. Please see Section 10 for additional information regarding behavioral healthcare parity. This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.
Cornerstone shall notify the LLC and confirm such advice in writing (i) when the filing of any post-effective amendment to the Registration Statement or supplement to the Prospectus is required, when the same is filed and, in the case of the Registration Statement and any post-effective amendment, when the same becomes effective, (ii) of any request by the Securities and Exchange Commission for any amendment of or supplement to the Registration Statement or the Prospectus or for additional information and (iii) of the entry of any stop order suspending the effectiveness of the Registration Statement or the initiation or threatening of any proceedings for that purpose, and, if such stop order shall be entered, Cornerstone shall use its best efforts promptly to obtain the lifting thereof.
Mobility The ability to move indoors from room to room on level surfaces at the normal place of residence.
Mental Health Services This agreement covers medically necessary services for the treatment of mental health disorders in a general or specialty hospital or outpatient facilities that are: • reviewed and approved by us; and • licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a general or specialty hospital or outpatient facility. We review network and non-network programs, hospitals and inpatient facilities, and the specific services provided to decide whether a preauthorization, hospital or inpatient facility, or specific services rendered meets our program requirements, content and criteria. If our program content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below.
meminta nasihat daripada Pihak Xxxxxx dalam semua perkara berkenaan dengan jualan lelongan, termasuk Syarat-syarat Jualan (iii) membuat carian Hakmilik Xxxxx xxxxxx rasmi di Pejabat Tanah xxx/atau xxxx-xxxx Pihak-pihak Berkuasa yang berkenaan xxx (iv) membuat pertanyaan dengan Pihak Berkuasa yang berkenaan samada jualan ini terbuka kepada semua bangsa atau kaum Bumiputra Warganegara Malaysia sahaja atau melayu sahaja xxx juga mengenai persetujuan untuk jualan ini sebelum jualan lelong.Penawar yang berjaya ("Pembeli") dikehendaki dengan segera memohon xxx mendapatkan kebenaran pindahmilik (jika ada) daripada Pihak Pemaju xxx/atau Pihak Tuanpunya xxx/atau Pihak Berkuasa Negeri atau badan-badan berkenaan (v) memeriksa xxx memastikan samada jualan ini dikenakan cukai. HAKMILIK : Hakmilik strata bagi hartanah ini masih belum dikeluarkan HAKMILIK INDUK / NO. LOT : Pajakan Negeri 35263, Lot No.29096 MUKIM/DAERAH/NEGERI : Setapak / Kuala Lumpur / Wilayah Persekutuan Kuala Lumpur PEGANGAN : Pajakan selama 82-tahun berakhir pada 08/08/2085 KELUASAN LANTAI : 81.104 meter persegi ( 873 kaki persegi ) PEMAJU/PENJUAL : Mega Planner Jaya Sdn Bhd (326287-W)(Dalam Likuidasi) TUANPUNYA : Datuk Bandar Kuala Lumpur PEMBELI : Xxxxxxxx Bin Xxxxx @ Xxxx BEBANAN : Diserahhak kepada RHB Bank Berhad [196501000373 (6171-M)] Hartanah tersebut terletak di tingkat 9 pada bangunan apartment 14-tingkat terletak di Melati Impian Apartment, Setapak Fasa 1, Kuala Lumpur. Hartanah tersebut adalah sebuah unit apartment 3 xxxxx dikenali sebaga Xxxxx Pemaju No. 9, Tingkat No.9, Pembangunan dikenali sebagai Melati Impian Apartment Setapak Fasa 1, Kuala Lumpur xxx mempunyai alamat surat-xxxxxxxx xx Xxxx Xx. 0-0, Xxxxxx Impian Apartment, Xxxxx 0/00X, Xxxxx Xxxxxx, 00000 Xxxxx Xxxxxx, Xxxxxxx Xxxxxxxxxxx Xxxxx Xxxxxx. Harta ini dijual “keadaan seperti mana sediada” dengan harga rizab sebanyak RM 300,000.00 (RINGGIT MALAYSIA: TIGA RATUS RIBU SAHAJA) xxx tertakluk kepada syarat-syarat Jualan xxx melalui penyerahan hakkan dari Pemegang Serahak, tertakluk kepada kelulusan di perolehi oleh pihak Pembeli daripada pihak berkuasa, jika ada, termasuk semua terma, syarat xxx perjanjian yang dikenakan xxx mungkin dikenakan oleh Pihak Berkuasa yang berkenaan. Pembeli bertanggungjawab sepenuhnya untuk memperolehi xxx mematuhi syarat-syarat berkenaan daripada Pihak Berkuasa yang berkenaan, jika ada xxx semua xxx xxx perbelanjaan ditanggung xxx dibayar oleh Xxxxx Xxxxxxx.Pembeli atas talian (online) juga tertakluk kepada terma-terma xxx syarat-syarat terkandung dalam xxx.xxxxxxxxxxxxxxxx.xxx Pembeli yang berminat adalah dikehendaki mendeposit kepada Pelelong 10% daripada harga rizab dalam bentuk Bank Draf atau Cashier’s Order di atas nama RHB Bank Berhad sebelum lelongan awam xxx xxxx xxxx xxxxxx hendaklah dibayar dalam tempoh sembilan puluh (90) hari dari tarikh lelongan kepada RHB Bank Berhad melalui Bank Draf / XXXXXX. Butir-butir pembayaran melalui XXXXXX, xxxx berhubung dengan Tetuan Zahrin Emrad & Sujaihah. Untuk maklumat lanjut, xxxx berhubung dengan TETUAN ZAHRIN EMRAD & SUJIAHAH, yang beralamat di Suite 10.3, 10th Floor, Xxx Xxxx Building, Xx.00, Xxxxx Xxxx Xxxxxx, 00000 Xxxxx Xxxxxx. Tel: 00-0000 0000 / Fax: 00-0000 0000. [ Ruj: ZES/ZHR/RHB-FC/16250-17/0614-pae ], peguamcara bagi pihak pemegang xxxxx xxx atau pelelong yang tersebut dibawah.