MEMBER INTAKE AND ENROLLMENT Sample Clauses

MEMBER INTAKE AND ENROLLMENT. 1. Contractor will accept a Member assigned by CPSA Member Services. In the event that a Member's eligibility is questioned, the Contractor Appeals Process may be used. During the appeal, the Contractor will continue provision of Covered Services to the assigned Member.
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MEMBER INTAKE AND ENROLLMENT. 1. A CPSA intake and enrollment is conducted on all non-enrolled children referred for HB 2003 services by ADES, AOC, and ADJC.
MEMBER INTAKE AND ENROLLMENT. Referral to Project MATCH requires enrollment in the behavioral health system of care and provision of services in at least one other system as identified in sections I and K. Children and families referred to Project MATCH are enrolled and assigned to a children's provider network following CPSA established protocol prior to referral to Project MATCH. If a referral is made for a child not currently enrolled in CPSA, an intake is requested to determine the need for enrollment in the behavioral health system of care. -------------------------------------------------------------------------------- [LOGO] Community Partnership FEE FOR SERVICE and RISK-BASED of Southern Arizona AMENDMENT NO. 5 Regional Behavioral CHILDREN SERVICES Health Authority ------------------------------------------------- CONTRACT NUMBER: A0108 FY 01-02 --------------------------------------------------------------------------------
MEMBER INTAKE AND ENROLLMENT. If the liaison staff and service partner(s) (ADES, AOC, or ADJC) deems a referral to behavioral health services appropriate for a child, the liaison staff assures that a comprehensive intake appointment for assessment is scheduled within 5 business days. ADES family members who need individual services are referred to a CPSA Adult Comprehensive Service Network for intake and assessment.

Related to MEMBER INTAKE AND ENROLLMENT

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  • GENERAL SERVICE DESCRIPTION Service Provider currently provides active medical, pharmacy(Rx) and dental administration for coverages provided through Empire and Anthem (medical), Medco(Rx), MetLife(dental) and SHPS (FSA) (Empire, Anthem, Medco, MetLife and SHPS collectively, the “Vendors”) for its U.S. Active, Salaried, Eligible Employees (“Covered Employees”). Service Provider shall keep the current contracts with the Vendors and the ITT CORPORATION SALARIED MEDICAL AND DENTAL PLAN (PLAN NUMBER 502 EIN 00-0000000) and the ITT Salaried Medical Plan and Salaried Dental Plan General Plan Terms (collectively, the “Plans”) and all coverage thereunder in full force through December 31, 2011 for Service Recipient’s Covered Employees. All claims of Service Recipient’s Covered Employees made under the Plans and incurred on or prior to December 31, 2011 the (“2011 Plan Year”) will be adjudicated in accordance with the current contract and Service Provider will continue to take such actions on behalf of Service Recipient’s Covered Employees as if such employees are employees of Service Provider. All medical, dental, pharmacy and FSA claims of Service Recipient’s Covered Employees made under the Plans (the “Claims”) will be paid by the Vendors on behalf of the Service Provider. Service Recipient will pay Service Provider for coverage based on 2011 budget premium rates previously set for the calendar year 2011 and described in the “Pricing” section below. Service Recipient will pay Service Provider monthly premium payments for this service, for any full or partial months, based on actual enrollment for the months covered post-spin using enrollments as of the first (1st) calendar day of the month, commencing on the day after the Distribution Date. Service Recipient will prepare and deliver to Service Provider a monthly self xxxx containing cost breakdown by business unit and plan tier as set forth on Attachment A, within five (5) Business Days after the beginning of each calendar month. The Service Recipient will be required to pay the Service Provider the monthly premium payments within ten (10) Business Days after the beginning of each calendar month. A detailed listing of Service Recipient’s employees covered, including the Plans and enrollment tier in which they are enrolled, will be made available to Service Provider upon its reasonable request. Service Provider will retain responsibility for executing funding of Claim payments and eligibility management with Vendors through December 31, 2013. Service Provider will conduct a Headcount True-Up (as defined below) of the monthly premiums and establish an Incurred But Not Reported (“IBNR”) claims reserve for Claims incurred prior to December 31, 2011 date, but paid after that date, and conduct a reconciliation of such reserve. See “Headcount True-Up” and “IBNR Reconciliation” sections under Additional Pricing for details.

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