Member Grievance Dispute Resolution Sample Clauses

Member Grievance Dispute Resolution. Provider agrees to (a) cooperate with and participate in Company’s applicable appeal, grievance and external review procedures (including, but not limited to, Medicaid appeals and expedited appeals procedures), (b) provide Company with the information necessary to resolve same, and (c) abide by decisions of the applicable appeals, grievance and review committees. Company will make available to Provider information concerning the Member appeal, grievance and external review procedures at the time of entering into this Agreement.
Sample 1Sample 2Sample 3See All (6)
AutoNDA by SimpleDocs
Member Grievance Dispute Resolution. Hospital agrees to (a) cooperate with and participate in Company’s applicable appeal, grievance and external review procedures (including, but not limited to, Medicaid appeals and expedited appeals procedures), (b) provide Company with the information necessary to resolve same, and (c) abide by decisions of the applicable appeals, grievance and review committees. Company will make available to Hospital information concerning the Member appeal, grievance and external review procedures at the time of entering into this Agreement.
Sample 1
Member Grievance Dispute Resolution. The following shall be added at the end of Section 8.1
Sample 1
Member Grievance Dispute Resolution. “As required by State law, Provider shall post a notice to Members on the process for resolving complaints with Company including the Department of Insurance toll-free telephone number for filing complaints. Company shall not terminate or refuse to renew this Agreement or otherwise retaliate against Provider because Provider reasonably filed a complaint or an appeal on behalf of a Member.”
Sample 1
Member Grievance Dispute Resolution. The Section of the Agreement titled “Member Grievance Dispute Resolution” shall be deleted in its entirety and replaced with the following: Provider agrees to (a) cooperate with and participate in Company’s applicable appeal, grievance and external review procedures (including, but not limited to, Medicaid appeals and expedited appeals procedures); (b) provide Company with the information necessary to resolve same; and (c) abide by decisions of the applicable appeals, grievance and review committees. Company will make available to Provider information concerning the Member appeal, grievance and external review procedures at the time of entering into the Agreement. As required by state law, Provider shall post a notice to Members on the process for resolving complaints with Company including the Department of Insurance toll- free telephone number for filing complaints. TEX. INS. CODE § 843.283; 28 TEX. ADMIN. CODE § 11.901(b)(4). Company shall not terminate or refuse to renew the Agreement or otherwise retaliate against Provider because Provider reasonably filed a complaint or an appeal on behalf of a Member. TEX. INS. CODE § 843.281; 28 TEX. ADMIN. CODE § 11.901(b)(1).
Sample 1
Member Grievance Dispute Resolution. Group and Participating Group Physicians agree to (a) cooperate with and participate in Company’s applicable appeal, grievance and external review procedures (including, but not limited to, Medicaid appeals and expedited appeals procedures), (b) provide Company with the information necessary to resolve same, and (c) abide by decisions of the applicable appeals, grievance and review committees. Company will make available to Group and Participating Group Physicians information concerning the Member appeal, grievance and external review procedures at the time of entering into this Agreement.
Sample 1
Member Grievance Dispute Resolution. Group and Participating Group providers agree to (a) cooperate with and participate in Company’s applicable appeal, grievance and external review procedures (including, but not limited to, medical necessity appeals and expedited appeals procedures) for Members, (b) provide Company with the information necessary to resolve same, and (c) abide by decisions of the applicable appeals, grievance and review committees. As required by State law, Group and Participating Group Provider’s, if applicable, shall post in Physician’s office a notice to Members on the process for resolving complaints with Company including the Department of Insurance toll-free number for filing complaints. Company shall not terminate or refuse to renew this Agreement or otherwise retaliate against Group or Participating Group Provider because Group and Participating Group Provider reasonably filed a complaint or an appeal on behalf of a Member.
Sample 1
AutoNDA by SimpleDocs
Member Grievance Dispute Resolution. Facility agrees to: (a) cooperate with, participate in and abide by decisions of Company’s applicable medical necessity appeal, grievance and external review procedures for Members (including, but not limited to, Medicare appeals and expedited appeals procedures); and (b) provide Company with the information necessary to resolve same.
Sample 1
Member Grievance Dispute Resolution. Laboratory agrees to (a) cooperate with and participate in Xxxxxxx Xxxxx Plus’s procedures, appeal process, grievances, and external review procedures, (b) provide the information necessary to resolve the claim, grievance or complaint, and (c) abide to the decisions of the applicable appeals, grievance and review committees. Xxxxxxx Xxxxx Plus will make available to Laboratory information concerning the Member appeal, grievance and external review procedures at the time of entering into this Agreement.
Sample 1

Related to Member Grievance Dispute Resolution

  • Dispute Resolution All or any disputes arising out or touching upon or in relation to the terms and conditions of this Agreement, including the interpretation and validity of the terms thereof and the respective rights and obligations of the Parties, shall be settled amicably by mutual discussion, failing which the same shall be settled through the adjudicating officer appointed under the Act.

  • Informal Dispute Resolution Prior to the initiation of formal dispute resolution procedures, the Parties shall first attempt to resolve their Dispute informally, in a timely and cost-effective manner, as follows:

  • Third Party Dispute Resolution The Consulting Firm shall (i) consider only the items that are then disputed by the parties, (ii) shall be bound by the terms of the Agreement and (iii) shall only make a determination of such disputed matters in favor of the proposal made by the Purchasers or the Sellers (as may be presented by each party to the Consulting Firm in writing, which shall be shared with the other party) and shall not make an independent proposal. The Consulting Firm shall prepare a written determination of any disputed matters and deliver the determination to the Purchasers and the Sellers within fifteen (15) Business Days after the date the Consulting Firm is engaged. Each party shall cooperate fully with the Consulting Firm, including by using reasonable best efforts to provide the information, data and work papers to the extent permitted by applicable Law, so as to enable the Consulting Firm to make a determination of the disputed items as quickly as practicable. The Corrective Action Plan shall be finalized in accordance with the Consulting Firm’s determination of the disputed matters.

  • Dispute Resolution Process Any claim, dispute or other matter in question not resolved by the process identified in Paragraph

  • Dispute Resolution Procedure 21.1 All disputes or grievances arising between the Parties shall as far as practical be resolved at the workplace level through consultation. Accordingly the following procedure must be followed:

  • Alternate Dispute Resolution In the event of any issue of controversy under this Agreement, the PARTIES may pursue Alternate Dispute Resolution procedures to voluntarily resolve those issues. These procedures may include, but are not limited to, conciliation, facilitation, mediation, and fact finding.

  • Dispute Resolutions Parties agree to arbitration of dispute in Houston, Texas, USA.

  • Applicable Law; Dispute Resolution i. This Agreement, and all claims, disputes or disagreements arising out of or connected with this Agreement, its validity or any breach thereof, shall be governed by the laws in effect in the State of Texas (excluding conflicts of laws provisions), and to the extent applicable to maritime issues, the maritime laws of the United States (excluding conflict of laws provisions).

  • Governing Law; Dispute Resolution This Agreement shall be subject to the provisions of Sections 9(a), 9(c), and 9(h) of the Employment Agreement.

  • Arbitration Dispute Resolution Company and Executive express expressly agree that, except for disputes arising out of alleged violations related to proprietary inventions and confidential information, all disputes arising out of this Agreement shall be resolved by arbitration in accordance with the following provisions. Either party must demand in writing such arbitration within one hundred and twenty (120) days after the controversy arises by sending a notice to arbitrate to both the other party and to the American Arbitration Association (“AAA”). The controversy shall then be arbitrated, pursuant to the rules promulgated by the AAA (the “Rules”), in the state of California. The parties will select by mutual agreement the arbitrator or arbitrators to herein resolve the controversy; provided, however, that, the parties cannot mutually agree as to the arbitrator, then the arbitrator shall be selected by the AAA in accordance with the Rules. The arbitrator’s decision shall be final and binding on the parties and shall bar any suit, action or proceeding instituted in any federal, state or local courts for administrative tribunal. Notwithstanding the preceding sentence, the arbitrator’s judgment may be entered in any court of competent jurisdiction. Disputes arising under the sections for compensation and termination upon compensation may be litigated and injunctive relief sought in any court having jurisdiction over the subject matter of such dispute.

Time is Money Join Law Insider Premium to draft better contracts faster.