Medi-Cal Services Sample Clauses

Medi-Cal Services a. Develop reimbursement methodologies for the payment of MCH care services. b. Support the retention of culturally and linguistically competent, and geographically strategic, safety net and traditional providers of MCH services who have a positive track record of serving the Medi-Cal population. c. Develop, in cooperation with MCH and CMS, provider manuals, billing instructions, and provider training. d. Develop, in cooperation, health care standards, etc.
Sample 1
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Medi-Cal Services a. Collaborate in developing standards. b. Participate and collaborate in the development of program policies, etc. c. Establish quality improvement standards. d. Collaborate in setting standards for services. e. Participate with MCH and CMS in the oversight and monitoring of services.
Sample 1
Medi-Cal Services a. Refer potentially eligible Medi-Cal beneficiaries to the CCS program. b. Develop eligibility procedures. c. Develop and produce outreach materials and oversee the implementation of outreach campaigns. d. Develop and implement Medi-Cal provider recruitment. e. Maintain a MCH provider resource directory and database.
Sample 1
Medi-Cal Services a. Seek input from Title V staff into the development of Medi-Cal fee-for-service and managed care rates and reimbursement mechanisms. b. Reimburse Title V contractors and providers, etc. with current Medi-Cal rates and fees for all services within the scope of Medi-Cal benefits. c. Reimburse authorized providers for services delivered to Medi-Cal beneficiaries with CCS- eligible conditions.
Sample 1

Related to Medi-Cal Services

  • Technical Services Party B will provide technical services and training to Party A, taking advantage of Party B’s advanced network, website and multimedia technologies to improve Party A’s system integration. Such technical services shall include: (a) administering, managing and maintaining Party A’s information application system and website system infrastructure; (b) providing system optimization plans and implementing optimization features; (c) assuring the security and reliability of the website application systems; (d) procuring, installing and supporting the relevant products produced by Party B, and providing training in the use of those products; (e) managing and maintaining all network and providing technologies to assure the reliability and efficiency thereof; (f) providing information technology services and assuring the reliable operation of the information infrastructure.

  • Surgical Services All necessary procedures for extractions and other surgical procedures normally performed by a dentist.

  • Medical Services We do not Cover medical services or dental services that are medical in nature, including any Hospital charges or prescription drug charges.

  • Medical Services Plan Regular Full-Time and Temporary Full-Time Employees shall be entitled to be covered under the Medical Services Plan commencing the first day of the calendar month following the date of employment. The City shall pay one hundred percent (100%) of the premiums required by the plan.

  • ELECTRICAL SERVICES The Company must construct and reticulate electrical requirements for all amenities and facilities. The Company must construct sub-station and distribution boards necessary to reticulate power to all Company owned or leased facilities which provide amenities to the public. The electrical installation must be to the design and installation standards of the State Energy Commission of Western Australia. All electrical reticulation must be placed underground.

  • Dental Services The following dental services are not covered, except as described under Dental Services in Section 3: • Dental injuries incurred as a result of biting or chewing. • General dental services including, but not limited to, extractions including full mouth extractions, prostheses, braces, operative restorations, fillings, frenectomies, medical or surgical treatment of dental caries, gingivitis, gingivectomy, impactions, periodontal surgery, non-surgical treatment of temporomandibular joint dysfunctions, including appliances or restorations necessary to increase vertical dimensions or to restore the occlusion. • Panorex x-rays or dental x-rays. • Orthodontic services, even if related to a covered surgery. • Dental appliances or devices. • Preparation of the mouth for dentures and dental or oral surgeries such as, but not limited to, the following: o apicoectomy, per tooth, first root; o alveolectomy including curettage of osteitis or sequestrectomy; o alveoloplasty, each quadrant; o complete surgical removal of inaccessible impacted mandibular tooth mesial surface; o excision of feberous tuberosities; o excision of hyperplastic alveolar mucosa, each quadrant; o operculectomy excision periocoronal tissues; o removal of partially bony impacted tooth; o removal of completely bony impacted tooth, with or without unusual surgical complications; o surgical removal of partial bony impaction; o surgical removal of impacted maxillary tooth; o surgical removal of residual tooth roots; and o vestibuloplasty with skin/mucosal graft and lowering the floor of the mouth. • The following dialysis services received in your home: o installing or modifying of electric power, water and sanitary disposal or charges for these services; o moving expenses for relocating the machine; o installation expenses not necessary to operate the machine; and o training in the operation of the dialysis machine when the training in the operation of the dialysis machine is billed as a separate service. • Dialysis services received in a physician’s office.

  • Legal Services If this Agreement is for legal services, this section is applicable. Contractor shall: (i) adhere to legal cost and billing guidelines designated by the JBE; (ii) adhere to litigation plans designated by the JBE, if applicable; (iii) adhere to case phasing of activities designated by the JBE, if applicable; (iv) submit and adhere to legal budgets as designated by the JBE; (v) maintain legal malpractice insurance in an amount not less than the amount designated by the JBE; and (vi) submit to legal bill audits and law firm audits if so requested by the JBE, whether conducted by employees or designees of the JBE or by any legal cost-control provider retained by the JBE for that purpose. Contractor may be required to submit to a legal cost and utilization review as determined by the JBE. If (a) the Contract Amount is greater than $50,000, (b) the legal services are not the legal representation of low- or middle-income persons, in either civil, criminal, or administrative matters, and (c) the legal services are to be performed within California, then Contractor agrees to make a good faith effort to provide a minimum number of hours of pro xxxx legal services, or an equivalent amount of financial contributions to qualified legal services projects and support centers, as defined in section 6213 of the Business and Professions Code, during each year of the Agreement equal to the lesser of either (A) thirty (30) multiplied by the number of full time attorneys in the firm’s offices in California, with the number of hours prorated on an actual day basis for any period of less than a full year or (B) the number of hours equal to ten percent (10%) of the Contract Amount divided by the average billing rate of the firm. Failure to make a good faith effort may be cause for nonrenewal of this Agreement or another judicial branch or other state contract for legal services, and may be taken into account when determining the award of future contracts with a Judicial Branch Entity for legal services.

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia.

  • Professional Services Bodily injury" or "property damage" arising out of the rendering of or failure to render profes- sional services;

  • Pharmacy Services The Contractor shall establish a network of pharmacies. The Contractor or its PBM must provide at least two (2) pharmacy providers within thirty (30) miles or thirty (30) minutes from a member’s residence in each county, as well as at least two (2) durable medical equipment providers in each county or contiguous county.

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