Member Eligibility Sample Clauses
POPULAR SAMPLE Copied 2 times
Member Eligibility. Verify Member eligibility contemporaneous with the rendering of services. BCBS will provide systems and/or methods for verification of eligibility and benefit coverage for Members. This is furnished as a service and not as a guarantee of payment;
Member Eligibility. Vendor will inform any prospective Government Unit, it must complete forms with MMCAP Infuse before it can access the pricing and benefits of this Agreement.
Member Eligibility. You are a Member of this Plan if you are enrolled as a Subscriber or Dependent of the Subscriber. If this Plan is being offered through the Marketplace, the Marketplace will make eligibility determinations in accordance with applicable law and based upon your Application. If you purchased this Plan direct from Health Options, we will make eligibility determinations in accordance with applicable law, your Application, and payment of the initial Premium. Subscribers must reside in Maine.
Member Eligibility. ☒ Only full-benefit dually eligible beneficiaries (QMB Plus, SLMB Plus and Other Full Benefit Dually Eligible Beneficiaries only) ☐ QMB ☒ QMB Plus ☐ QI ☐ QDWI ☒ Other Full Benefit Dual Eligible (FBDE) Beneficiaries (non-QMB)
Member Eligibility. ☒ Only full-benefit dually eligible beneficiaries (QMB Plus, SLMB Plus and Other Full Benefit Dually Eligible Beneficiaries only as per applicable monthly capitation reimbursement rate codes at Attachment 7) ☐ QMB ☒ QMB Plus ☐ QI ☐ QDWI ☒ Other Full Benefit Dual Eligible (FBDE) Beneficiaries (non-QMB)
Member Eligibility. ☐ AHCCCS Acute Program ☒ QMB+ ☐ Integrated RBHA Maricopa County ☒ SLMB+ ☒ ALTCS Elderly and Physically Disabled ☒ FBDE (non-QMB) ☐ ALTCS Developmentally Disabled ☐ Children’s Rehabilitative Services
Member Eligibility. All Wings Members who are 18 years of age or older and have the legal capacity to enter into a binding contract are eligible to participate in the Program. To participate in the Program, Members must qualify for at least one product included in the Program. An Account will be established for the primary Member of an eligible product or service. A person who does not serve as the primary Member on an eligible account will not have an Account opened until such time they become a primary Member on an eligible product or service.
Member Eligibility. A Service provided to an Eligible Member can be submitted to HBF for a claim under the terms of this Agreement, if:
(a) the Service is eligible for a Medicare benefit and a Medicare item number is provided for each Service
(b) where the Services were performed in a public hospital, the Eligible Member was validly admitted to the public hospital as a private patient, including meeting recognised industry guidelines for such admissions;
(c) no compensation, damages or benefits may be claimed from another source for the Service to the Eligible Member; and
(d) the account is unpaid and sent directly to HBF by, or on behalf, of the Practitioner.
Member Eligibility. You understand that you must be a member in good standing to be eligible to enroll in or use RDC. Member in good standing means a member of the Credit Union for at least 90 days with no negative account balances, no past due loans and no dormant accounts. Also, you must be enrolled in online banking. You understand that we will notify you at the email address you provided of the status of your application for the RDCservice.
Member Eligibility. ☐ AHCCCS Complete Care (ACC) ☐ QMB+ ☐ Integrated RBHA ☐ SLMB+ ☐ ALTCS Elderly and Physically Disabled ☐ FBDE (non-QMB) ☐ ALTCS Developmentally Disabled (DD) ☐ Children’s Rehabilitative Services (CRS) (for the ALTCS Developmentally Disabled [DD] CRS subpopulation only)