Member Case Files Sample Clauses

Member Case Files. 4.4.11.1 The Care Coordination team shall maintain individual files for each Member. 4.4.11.2 Member case files must include, but are not limited to, the following, as applicable: 4.4.11.2.1 Pertinent demographic information regarding the Member including the name and contact information of any Representative and a list of other persons authorized by the Member to have access to health care (including Long-Term Care) related information; 4.4.11.2.2 The most current CCP, including the detailed plan for back-up Providers in situations when regularly scheduled Providers are unavailable or do not arrive as scheduled; 4.4.11.2.3 Written confirmation of the Member’s decision regarding participation in the Self-Directed Community Benefit; 4.4.11.2.4 A completed risk assessment and a risk agreement signed by the Member or his or her Representative; and for Members meeting a nursing facility level of care; 4.4.11.2.5 The most recent health risk assessment, Comprehensive Needs Assessment, level of care assessment and documentation of Care Coordination level; 4.4.11.2.6 Documentation of the Member’s choice of Contract Providers; 4.4.11.2.7 Signed consent forms as necessary in order to share Confidential Information with and among Providers consistent with all applicable State and federal statutes and regulations; and 4.4.11.2.8 A list of emergency contacts approved by the Member.
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Member Case Files. 2.9.6.9.6.1 The care coordinator/care coordination team shall maintain individual files for each assigned CHOICES member. 2.9.6.9.6.2 For members in CHOICES Group 1, the files shall contain at a minimum: 2.9.6.9.6.2.1 Pertinent demographic information regarding the member including the name and contact information of any representative and a list of other persons authorized by the member to have access to health care (including long-term care) related information; 2.9.6.9.6.2.2 Any supplements to the nursing facility plan of care, as applicable; 2.9.6.9.6.2.3 A signed acknowledgement of the member’s patient liability amount and the member’s understanding regarding his/her responsibility with respect to payment of patient liability, including the potential consequences for non-payment; and 2.9.6.9.6.2.4 Transition assessment and transition plan, if applicable. 2.9.6.9.6.3 For members in CHOICES Groups 2 or 3, the files shall contain at a minimum: 2.9.6.9.6.3.1 The most current plan of care, including the detailed plan for back-up providers in situations when regularly scheduled providers are unavailable or do not arrive as scheduled; 2.9.6.9.6.3.2 List of providers who will be providing home health, private duty nursing and HCBS paid for by other payors; 2.9.6.9.6.3.3 Written confirmation of the member’s decision regarding participation in consumer direction of HCBS; 2.9.6.9.6.3.4 For members who are self-directing any health care tasks, a copy of the physician’s order; 2.9.6.9.6.3.5 For members in CHOICES Group 2, a completed risk assessment and a risk agreement signed by the member or his/her representative; and documentation that the person’s needs can be safely and effectively met in the community and at a cost that does not exceed nursing facility care, including signed acknowledgement of understanding by the member or his/her representative that a change in needs or circumstances that would result in the cost neutrality cap being exceeded or that would result in the CONTRACTOR’s inability to safely and effectively meet the member’s needs in the community and within the cost neutrality cap may result in the member’s disenrollment from CHOICES Group 2; 2.9.6.9.6.3.6 For members in CHOICES Group 2, the cost neutrality cap provided by TENNCARE, a determination by the CONTRACTOR that the projected cost of HCBS, home health, and private duty nursing services will not exceed the member’s cost neutrality cap, and signed acknowledgement of understanding by the...

Related to Member Case Files

  • Grievance Files Written grievances and responses will be maintained separately from the employee’s personnel file.

  • EMPLOYEE FILES 10.01 A copy of any completed formal evaluation which is to be placed in an employee’s file shall be first reviewed with the employee. The employee shall initial such evaluation as having been read and shall have the opportunity to add her or his views to such evaluation prior to it being placed in her or his file. It is understood that such evaluations do not constitute disciplinary action by the Employer against the employee. Having provided a written request to the Director of Care, or her designate, an employee shall be entitled to her personnel file for the purpose of reviewing any evaluations or formal disciplinary notations contained therein, in the presence of the Director of Care, at a mutually agreeable time. 10.02 The Employer will accommodate reasonable requests for copies of performance appraisals and records of discipline in an employee's file. 10.03 Letters of discipline shall be removed from an employee's file eighteen (18) months following the receipt of such letters provided that the employee's disciplinary record has remained discipline free over the eighteen (18) months period. Leaves of absence in excess of thirty (30) continuous calendar days will not count towards the eighteen (18) months period noted above.

  • COMPUTER GRAPHICS FILES The Engineer agrees to comply with Attachment G, Computer Graphics Files for Document and Information Exchange, if determined by the State to be applicable to this contract.

  • Receivable Files There is only one original executed copy of each “tangible record” constituting or forming a part of such Receivable that is tangible chattel paper and a single “authoritative copy” (as such term is used in Section 9-105 of the UCC) of each electronic record constituting or forming a part of such Receivable that is electronic chattel paper. The Receivable Files that constitute or evidence such Receivable do not have any marks or notations indicating that they have been pledged, assigned or otherwise conveyed by the Seller to any Person other than the Issuer.

  • Personal Files 2.5.1 The employer shall ensure that personal files are held in a secure place and access is confined to authorised personnel and the employee concerned. 2.5.2 Attention is drawn to the Privacy Act 1993 which outlines responsibilities for the collection, storage and availability of personal information.

  • Receivable Files Complete There exists a Receivable File pertaining to each Receivable. Related documentation concerning the Receivable, including any documentation regarding modifications of the Contract, will be maintained electronically by the Servicer in accordance with customary policies and procedures. With respect to any Receivables that are tangible chattel paper, the complete Receivable File for each Receivable currently is in the possession of the Custodian.

  • Computer Files Marked The Seller shall, at its own expense, on or before the Closing Date, indicate in its computer files that the Receivables have been sold to the Purchaser pursuant to this Receivables Purchase Agreement and deliver to the Purchaser the Receivable Schedule, certified by an officer of the Seller to be true, correct and complete.

  • Review of Custodial Files The Custodian agrees, for the benefit of Certificateholders, to review, in accordance with the provisions of Section 2.01 of the Pooling and Servicing Agreement, each Custodial File. If in performing the review required by this Section 2.3 the Custodian finds any document or documents constituting a part of a Custodial File to be missing or defective in any material respect, the Custodian shall promptly so notify the Seller, the Master Servicer and the Trustee.

  • Student Records The School shall maintain student records for current and former students in accordance with the requirements of State and federal law, including the Family Education Rights and Privacy Act, 20 U.S.C. § 1232g, as may be amended from time to time.

  • Books and Records; Transfers of Mortgage Loans From and after the sale of the Mortgage Loans to the Purchaser all rights arising out of the Mortgage Loans including but not limited to all funds received on or in connection with the Mortgage Loans, shall be received and held by the Company in trust for the benefit of the Purchaser as owner of the Mortgage Loans, and the Company shall retain record title to the related Mortgages for the sole purpose of facilitating the servicing and the supervision of the servicing of the Mortgage Loans. The sale of each Mortgage Loan shall be reflected on the Company’s balance sheet and other financial statements as a sale of assets by the Company. The Company shall be responsible for maintaining, and shall maintain, a complete set of books and records for each Mortgage Loan which shall be marked clearly to reflect the ownership of each Mortgage Loan by the Purchaser. In particular, the Company shall maintain in its possession, available for inspection by the Purchaser, or its designee and shall deliver to the Purchaser upon demand, evidence of compliance with all federal, state and local laws, rules and regulations, including but not limited to documentation as to the method used in determining the applicability of the provisions of the Flood Disaster Protection Act of 1973, as amended, to the Mortgaged Property, documentation evidencing insurance coverage and eligibility of any condominium project for approval by Fxxxxx Mxx and periodic inspection reports as required by Section 4.13. To the extent that original documents are not required for purposes of realization of Liquidation Proceeds or Insurance Proceeds, documents maintained by the Company may be in the form of microfilm or microfiche or such other reliable means of recreating original documents, including but not limited to, optical imagery techniques. The Company shall maintain with respect to each Mortgage Loan and shall make available for inspection by any Purchaser or its designee the related Servicing File during the time the Purchaser retains ownership of a Mortgage Loan and thereafter in accordance with applicable laws and regulations. The Company shall keep at its servicing office books and records in which, subject to such reasonable regulations as it may prescribe, the Company shall note transfers of Mortgage Loans. No transfer of a Mortgage Loan may be made unless such transfer is in compliance with the terms hereof. For the purposes of this Agreement, the Company shall be under no obligation to deal with any person with respect to this Agreement or the Mortgage Loans unless the books and records show such person as the owner of the Mortgage Loan. The Purchaser may, subject to the terms of this Agreement, sell and transfer one or more of the Mortgage Loans, provided, however, that (i) the transferee will not be deemed to be a Purchaser hereunder binding upon the Company unless (a) such transferee shall agree in writing to be bound by the terms of this Agreement and an original counterpart of the instrument of transfer and an assignment and assumption of this Agreement in the form of Exhibit G hereto executed by the transferee shall have been delivered to the Company, or (b) the transferee is an affiliate of the Purchaser, a depositor, a trustee or any other appropriate party in a Pass-through Transfer and (ii) in no event shall there be more than five Persons at any given time having the status of “Purchaser” hereunder. The Purchaser also shall advise the Company of the transfer. Upon receipt of notice of the transfer, the Company shall mxxx its books and records to reflect the ownership of the Mortgage Loans of such assignee, and shall release the previous Purchaser from its obligations hereunder with respect to the Mortgage Loans sold or transferred.

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