Non-Certified Services Sample Clauses

Non-Certified Services. In the event that Practitioner fails to secure Certification from VBH for services that are included in the Member’s Plan, the Member shall not be held liable for the cost of such services. Practitioner may xxxx Members for services that are included the Member’s Plan but that are not Certified as Medically Necessary only if Practitioner has followed the procedures set forth in this Section 3.5. In the event that VBH notifies Practitioner that: (i) proposed treatment or services for a Member will not be Certified; or (ii) treatment or services for a Member which had previously been Certified will no longer be Certified, Practitioner may initiate an appeal of such non-Certification by following VBH’ appeals procedure as specified in the Provider Handbook. If a Member wishes to continue to receive such non-Certified treatment from Practitioner after the appeals process is completed and the non-Certification decision was upheld, Practitioner must obtain Member’s written consent to be financially responsible for any such non-Certified treatment or services received from Practitioner thereafter. Such Member’s consent must be in writing and signed and dated, and may not be obtained until after the date that the appeals process is completed. Any prior agreement by a Member to be financially responsible for non- Certified treatment or services shall be null and void and Practitioner agrees that he/she will not attempt to enforce any such agreement.
Sample 1
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Related to Non-Certified Services

  • COMPENSATION CERTIFICATION Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways: • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State. • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.)

  • DEBARMENT AND SUSPENSION CERTIFICATION 2 A. CONTRACTOR certifies that it and its principals:

  • Debarment and Suspension Certifica- tion Pursuant to 7 CFR Part 3017, Purchaser shall obtain certifications from its Subcontractors regarding debarment, suspension, ineligibility, and voluntary exclusion, including additional Subcontractors obtained after award of this contract. “Subcontractors” are participants in lower tier covered transactions. Purchaser may rely upon a certification of a prospective Subcontractor that it is not proposed for debarment under 48 CFR 9.4, debarred, suspended, ineligible, or voluntarily excluded from participating in covered transactions or timber sales, unless Purchaser knows that the certification is erroneous. Purchaser shall keep the certifications of its Subcontractors on file until timber sale Termination Date and any extensions thereof, and will provide a copy at the written request of Contracting Officer. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this Subsection. The knowledge and information of Purchaser is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. If Purchaser knowingly enters into a timber sale transaction with a person who is proposed for debarment under 48 CFR 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in covered transactions or timber sales, in addition to other remedies available to the Government, Forest Service may pursue available remedies, including suspension and/or debarment. The Subcontractor for a timber sale shall complete a “Subcontractor Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion.” An example of this certification is shown following the instructions for page 101 of this contract.

  • INDIVIDUAL SERVICES AGREEMENT This contract shall include an Individual Services Agreement (ISA) developed for each LEA pupil to whom CONTRACTOR is to provide special education and/or related services. An ISA shall only be issued for LEA pupils enrolled with the approval of the LEA pursuant to Education Code section 56366 (a)(2)(A). ISAs are void upon termination or expiration of the Master Contract. In the event that this Master Contract expires or terminates, CONTRACTOR and the LEA shall continue to be bound to all of the terms and conditions of the most recent executed ISAs between CONTRACTOR and LEA for so long as CONTRACTOR is servicing authorized LEA pupils, until such time as a new Master Contract is executed. Any and all changes to a LEA pupil’s educational placement/program provided under this Master Contract and/or an ISA shall be made solely on the basis of a revision to the LEA pupil’s IEP/IFSP. At any time during the term of this Master Contract, a LEA pupil’s parent, CONTRACTOR, or XXX may request a review of a LEA pupil’s IEP/IFSP subject to all procedural safeguards required by law, including notice to and participation by the CONTRACTOR in the IEP Team meeting. Unless otherwise provided in this Master Contract, the CONTRACTOR shall provide all services specified in the IEP/IFSP unless the CONTRACTOR and the LEA agree otherwise in the ISA. (California Education Code sections 56366(a) (5) and 3062(e)). In the event the CONTRACTOR is unable to provide a specific service at any time during the term of the ISA, the CONTRACTOR shall notify the LEA in writing within five (5) business days of the last date a service was provided. If a parent or XXX contests the termination of an ISA by initiating a due process proceeding with the California Office of Administrative Hearings (hereinafter referred to as “OAH”), CONTRACTOR shall abide by the “stay- put” requirement of state and federal law unless the parent agrees otherwise or an interim alternative educational placement is deemed lawful and appropriate by LEA or OAH. Disagreements between XXX and CONTRACTOR concerning the formulation of an ISA or the Master Contract may be appealed to the local SELPA office prior to appeal to the State Superintendent of Public Instruction pursuant to the provisions of California Education Code section 56366 (C) (2).

  • Cost Certification Redeveloper shall submit authentic documentation to the City on approved forms or format for payment of any expenses related to construction of the eligible Redeveloper Priority Expenses. Redeveloper shall timely submit receipts, invoices, or proof of payment concurrently with the request for reimbursement of eligible Redeveloper Priority Expenses. The City shall approve or reject the request for reimbursement with reasons stated, based on the review within ten (10) business days of receipt of the same. The foregoing notwithstanding, the City reserves the right during said ten (10) day period to request additional information and documentation related to a request for reimbursement from Redeveloper, and such a request by the City shall have the effect of restarting the ten (10) day period upon receipt of all requested information. Failure of the City to reject the request for reimbursement within said ten

  • Project Monitoring by the State The State may conduct on-site or off-site monitoring reviews of the Project during the term of this Grant Agreement and for up to ninety (90) days after it expires or is otherwise terminated. The Grantee shall extend its full cooperation and give full access to the Project site and to relevant documentation to the State or its authorized designees for the purpose of determining, among other things:

  • CONSTRUCTION AND RELATED ENGINEERING SERVICES A. General construction work for buildings (CPC 512) 1) Unbound* 2) None 3) None 1) Unbound* 2) None 3) None

  • Service Letters (97) The Company shall return to new employees, within thirty (30) days from the date of their employment, their service cards and letters of recommendation. An employee dismissed, or leaving the service with due notice shall, upon request, be given the usual certificate of service and will be paid as soon as possible.

  • Contractor’s Federal Employment Verification Certification The Contractor is registered with, authorized to use, is using and will continue to use, the federal work authorization program throughout the term of the contract, and holds the following authorization: User Identification Number: Date of Authorization: Date WITNESSETH, that the Contractor and the Owner, for the consideration set forth herein, the adequacy and sufficiency of which is hereby acknowledged by each party, agree as follows:

  • BANKRUPTCY, DEBARMENT, OR SUSPENSION CERTIFICATION Supplier certifies and warrants that it is not in bankruptcy or that it has previously disclosed in writing certain information to Sourcewell related to bankruptcy actions. If at any time during this Contract Supplier declares bankruptcy, Supplier must immediately notify Sourcewell in writing. Supplier certifies and warrants that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from programs operated by the State of Minnesota; the United States federal government or the Canadian government, as applicable; or any Participating Entity. Supplier certifies and warrants that neither it nor its principals have been convicted of a criminal offense related to the subject matter of this Contract. Supplier further warrants that it will provide immediate written notice to Sourcewell if this certification changes at any time.

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