Other Service Requirements. The CMHSP shall assure that in addition to those provisions specified in Part II, Section 3.0 “Access Assurance,” services are planned and delivered in a manner that reflects the values and expectations contained in the following guidelines:
A. Housing Practice Guideline (Attachment C 6.9.3.1)
B. Inclusion Practice Guideline (Attachment C 6.9.3.2) C. Consumerism Practice Guideline (Attachment C 6.9.3.3)
Other Service Requirements. The PIHP shall assure that in addition to those provisions specified in Section 4.0 “Access Assurance,” services are planned and delivered in a manner that reflects the values and expectations contained in the following guidelines:
A. Inclusion Practice Guideline (Attachment P 6.8.2.1) B. Housing Practice Guideline (Attachment P 6.8.2.2) C. Consumerism Practice Guideline (Attachment P 6.8.2.3) D. Personal Care in Non-Specialized Home Guideline (Attachment P 6.8.2.4) In addition, the PIHP must disseminate all practice guidelines it uses to all affected providers and upon request to beneficiaries. The PIHP must ensure that decisions for utilization management, beneficiary education, coverage of services, and other areas to which the guidelines apply are consistent with the guidelines.
Other Service Requirements a. The Health Plan shall meet the minimum service requirements as outlined and defined in Attachments I and II of this Contract.
b. Health plans serving Reform populations agree to provide the services listed in Section G. of this attachment in accordance with Contract provisions.
c. The Health Plan shall submit for approval any changes to the optional services listed in Table 5 and expanded services listed in Table 6 and, for health plans serving Reform populations, those covered services listed in Section G. below, to the Agency’s Bureau of Health Systems Development (HSD) by June 15 of each contract year. These services may be changed on a contract year basis and only if approved by the Agency in writing.
d. The Health Plan shall use the following service provisions for prescribed drug services as allowed in Attachment II, Section V, Covered Services, and as listed by “X” below.
Other Service Requirements a. The Health Plan shall meet the minimum service requirements as outlined and defined in Attachment I, Scope of Services, and Attachment II, Core Contract Provisions, of this Contract.
b. Health plans serving Reform populations agree to provide the services listed in Attachment I, Scope of Services, Section G., Benefit Grid/Customized Benefit Package - Reform Capitated Plans Only, in accordance with Contract provisions.
c. The Health Plan shall submit for approval any changes to the optional services listed in Table 5 and expanded services listed in Table 6 and, for health plans serving Reform populations, those covered services listed in Section G., Benefit Grid/Customized Benefit Package - Reform Capitated Plans Only, to HSD by June 15th of each contract year or by the date specified in writing by the Agency. These services may be changed on an annual basis and only if approved by the Agency in writing.
d. The Health Plan shall use the following service provisions for prescribed drug services as allowed in Attachment II, Core Contract Provisions, Section V, Covered Services, and as denoted by an “X” in Table 7 below. The Health Plan shall use a pharmacy benefits manager as specified in Attachment II, Core Contract Provisions, Section V, Covered Services. X WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract
e. The Health Plan has agreed to and is authorized by the Agency to use the Medicaid redetermination date data provided in its enrollment files as specified in Attachment II, Core Contract Provisions, Section IV, Enrollee Services, Community Outreach and Marketing, only if denoted by an “X” in Table 8 below. The Health Plan shall use Medicaid redetermination date data as specified in Attachment II, Core Contract Provisions, Section IV, Enrollee Services, Community Outreach and Marketing. X
f. The Health Plan has agreed to and is authorized by the Agency to provide services through telemedicine and as specified in Attachment II, Core Contract Provisions, Section V, Covered Services, Item H., Coverage Provisions, sub-item 22., Telemedicine; Section VI, Behavioral Health Care, Item A., General Provisions; and Exhibit 5, Covered Services, only if denoted by an “X” in Table 9 below. The Health Plan shall provide telemedicine as specified in Attachment II, Core Contract Provisions, Section V, Covered Services, Item H., Coverage Provisions, sub-item 22., Telemedicine; Section VI, Behavioral Health Care, Item A., General Provisions; and Exhibit 5, Co...
Other Service Requirements. The Managed Care Plan shall meet the minimum service requirements as outlined and defined in Attachment II, Core Contract Provisions.
Other Service Requirements. 6.12.1 Participate in Client Intervention Meetings as required by ADMINISTRATOR.
6.12.2 Refer PARTICIPANT(s) to services as necessary to address and overcome barriers to participation. Services include, but are not limited to: Domestic Abuse Services, Mental Health and Substance Use Services, Workforce Investment Boards (WIB), community colleges, Adult Basic Education, Regional Occupational Programs, and job fairs.
6.12.3 After PARTICIPANT(s)’ initial referral is sent to a service provider, CONTRACTOR shall complete follow-up contact within seven (7) business days to ensure the referral was successful.
6.12.4 Maintain ongoing communication with ADMINISTRATOR and/or other service providers to ensure a common understanding of PARTICIPANT(s)’ participation status and/or needs.
6.12.5 Participate in all Cal-OAR efforts as required by ADMINISTRATOR;
6.12.6 Provide Case Management Services to WTW Exempt Volunteers as required by ADMINISTRATOR.
6.12.7 Provide services that are in alignment with State and Federal Work Participation Rate requirements.
Other Service Requirements a. The Health Plan shall meet the minimum service requirements as outlined and defined in Attachments I and II of this Contract.
b. Health plans serving Reform populations agree to provide the services listed in Section G. of this attachment in accordance with Contract provisions.
Other Service Requirements. Specifications Reference Description of Services Specified Requirements
Other Service Requirements. 1. Provide staff support to facilitate and implement the employee wellness program, to improve employee health overall and reduce employee and retiree health-care costs, both in the short and long- term.
2. Develop and/or purchase at no additional charge to the County technologies/systems to administer and support the FSA and HRA programs, on-line enrollments, employee changes and education, employees/retirees self-enrollment and self-management of benefits, and to relieve related administrative demands on County staff.
3. Provide support to the Retiree Administration Program, Medicare Advantage program and related services as needed.
4. Provide and facilitate ongoing COBRA administration Program including COBRA premium payments, FSA and HRA program set-up and execution.
5. Recommend and help develop enhancements and improvements for communication specific to the needs of County's employees and retirees, including but not limited to brochures, pamphlets, comparison charts, summaries, electronic communication, forms, employee handbooks and employee orientation.
6. Provide timely and accurate research and responses to technical questions posed by County staff.
7. Provide regular and timely communications and support as needed for the effective administration of benefit plans, including newsletters, training, quarterly utilization meetings for leadership, and semi-annual utilization meetings for non-management staff.
8. Provide guidance and recommendations on items such as, but not limited to, trends in benefits plans, methods for improving cost containment, financial arrangements and administration.
9. Facilitate and provide access to benefit-related survey processes and information.
10. Develop additional benefits communications specific to the needs of the County's employees and retirees.
11. Attend and provide needed assistance in meetings with the County Board of Commissioners, County staff and other meetings as required.
12. Recommend consultant-sponsored seminars, benefits events and educational forums that would be beneficial to the County and/or County staff.
13. Develop, facilitate and evaluate employee and retiree needs and satisfaction surveys.
14. Work collaboratively with other Consultants as well as County staff, and manage plan transitions as necessary.
15. Review and evaluate current administrative processes related to enrollment and billing. Recommend and assist with implementation of administrative process enhancements as needed.
Other Service Requirements. 1. Party B shall announce the number of message to users when delivering any information services to users;
2. For group dispatch through Internet by users, communication and information service fees shall be charged to calling parties pursuant to the number of phone numbers and the relevant charging standards. The maximum number of each group dispatch shall not be more than two.
3. Party B must provide, free of charge, to users the service code for cancellation of any services that have been customized, which means, when a user sends “0000” to Party B’s service code, all the services customized by such user shall be cancelled and a reply will be sent out with the following messages: “You have not customized XX (Party B’s name) to provide the SMS services. Customer hotline: XXXX-XXXX” or “You have cancelled the customized SMS services provided by XX (Party B’s name). Customer hotline: XXXX-XXXX”;
4. After the 15th day of each month, Party A will provide the number segment data documents of the previous month for every province of the entire network in the catalog of ftp: //000.00.000.00 (user ID/password: Unicom/telseseg) and Party B shall update the number segment documents for business system users within that month and operate its businesses at its new number segments from the 1st day of the following month. All the number segment files will be kept on line for two months.
