Member Eligibility Data Sample Clauses

Member Eligibility Data. ‌ The Reporting Entity’s Member ID (Member Suffix or Sequence Number) must be unique to an individual. The unique identifier in the eligibility file must be consistent with the unique identifier in the medical claims/pharmacy file. This provides linkage between medical and pharmacy claims during established coverage periods and is critical for the implementation of Episode of Care reporting. For Historic Data Submissions, report eligibility for all Members during each reporting month. If historical address data is not available, report historical months’ eligibility data based on Member’s last known or current address. To reconcile the total number of Members in the historical data submissions, each Reporting Entity shall submit a summary report that totals the number of Members for each month for Historic Data. Member Eligibility files must be formatted to provide one record per member per month.
Sample 1
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Related to Member Eligibility Data

  • 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;

  • Contribution Eligibility You are eligible to make a regular contribution to your Xxxx XXX, regardless of your age, if you have compensation and your MAGI is below the maximum threshold. Your Xxxx XXX contribution is not limited by your participation in an employer-sponsored retirement plan, other than a Traditional IRA.

  • Program Eligibility 1. All officers, regardless of assignment, will be eligible for the vehicle program subject to the limitations set forth below.

  • Service Eligibility A bonus authorized by subsection (a) may be paid to a person or offi- cer only if the person or officer agrees under subsection (d)—

  • Client Eligibility Client eligibility and service referral are the responsibility of DDA under chapter 388- 823 WAC (Eligibility) and chapter 388-825 WAC (Service Rules). Only persons referred by DDA shall be eligible for direct Client services under this Program Agreement. It is DDA’s responsibility to determine and authorize the appropriate direct service(s) type. Direct Client services provided without authorization are not reimbursable under this Program Agreement.

  • TAX LIMITATION ELIGIBILITY In order to be eligible and entitled to receive the value limitation identified in Section 2.4 for the Qualified Property identified in Article III, the Applicant shall:

  • Benefit Eligibility For purposes of the Benefit Plan entitlement, common-law and same sex relationships will apply as defined.

  • Student Eligibility A. The Texas Success Initiative (TSI) requires mandatory assessment for all students to determine college readiness in reading, writing and math. The xxxx authorizes the Texas Higher Education Coordinating Board to prescribe assessment instruments with a statewide passing standard. The initiative allows an institution to determine when a student is ready to perform college‐level coursework. High School students who seek to register in a dual credit course, which will grant college credit must prove “college readiness” by achieving a college level score as outlined in Appendix A.

  • Full Employer Contribution - Basic Eligibility Employees covered by this Agreement who are scheduled to work at least seventy-five (75) percent of the time are eligible for the full Employer Contribution. This means:

  • Group Benefits Eligibility 7.2.1 Participation in the Plan shall be a condition of employment for all teachers commencing employment for a full school year.

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