PCP Assignment Sample Clauses

PCP Assignment a. In the event that the Contractor is unable to elicit a PCP selection from an Enrollee, the Contractor shall promptly assign a PCP to each such Enrollee as described below. Such assignment shall be to the most appropriate PCP in accordance with this Contract and EOHHS policies and shall be effective no later than 15 days after the Effective Date of Enrollment in the Contractor’s Plan. b. The Contractor shall, at a minimum, determine whether the assigned Enrollee has received services under the Contractor’s Plan within the previous year under MassHealth or a commercial membership. 1) If the assigned Enrollee was previously enrolled with the Contractor’s Plan, then the assignment shall be to the Enrollee’s most recent PCP if, in the Contractor’s reasonable judgment, such assignment is appropriate. 2) If the assigned Enrollee was not previously enrolled with the Contractor’s Plan, then the Contractor shall make its best efforts to seek and obtain pertinent information from the Enrollee to assign the Enrollee to an appropriate PCP, considering all sources of information available to the Contractor, including but not limited to, information provided by EOHHS or its CSC Enrollment Vendor. The Contractor shall, based on such information that it is able to obtain in a timely manner, take into account factors that include, but are not limited to, the following: a) Available information on the Enrollee’s health care needs, including Behavioral Health Services needs; b) PCP training and expertise with demographic or special populations similar to the Enrollee, including children in the care or custody of DCF or youth affiliated with DYS (either detained or committed) and homeless persons; c) Geographical proximity of PCP site(s) to the Enrollee’s residence; d) Whether the PCP site is accessible by public transportation; e) Whether the PCP site is accessible to people with disabilities; f) The Enrollee’s preferred language and capabilities of the PCP to practice in that language; and g) Access to skilled medical interpreters who speak the Enrollee’s preferred language at the PCP site. c. The Contractor shall inform the Enrollee of the name of the PCP to whom he or she is assigned and offer to assist the Enrollee in scheduling an initial appointment with the PCP. d. The Contractor shall routinely and promptly inform PCPs of newly assigned Enrollees and shall require PCPs to make best efforts to schedule an initial appointment with new Enrollees. e. The Contractor sha...
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PCP Assignment. 2.10.4.1. The Contractor will allow each Enrollee to choose his or her PCP to the extent possible and appropriate. If the Enrollee does not select a PCP within thirty (30) calendar days of the effective coverage date, Contractor shall assign that Enrollee to a PCP and notify the Enrollee and the assigned PCP in writing no later than forty (40) calendar days after the Enrollee’s coverage date. 2.10.4.2. If an Enrollee does not select a PCP within thirty (30) calendar days of the effective date of coverage date, Contractor shall use FFS utilization data or other data sources, including electronic data, to: 2.10.4.2.1. Establish existing provider relationships for the purpose of PCP assignment, including a specialist or clinic, if an Enrollee indicates a preference for either. Contractor shall comply with all federal and State Privacy laws in the provision and use of this data. 2.10.4.3. Contractor shall notify the PCP that an Enrollee has selected or been assigned to the PCP within ten (10) calendar days from when selection or assignment is completed by the Enrollee or the Contractor, respectively. 2.10.4.4. Contractor shall maintain procedures that proportionately include contracting traditional and safety-net providers in the assignment process for Enrollees who do not choose a PCP. 2.10.4.5. If, at any time, an Enrollee notifies the Contractor of a PCP choice, such choice shall override Enrollee assignment to a PCP in accordance with applicable DPL(s) as indicated in Section 2.1.5.
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PCP Assignment. 2.10.4.1. If the Enrollee does not select a PCP within thirty (30) calendar days of the effective coverage date, Contractor shall assign that Enrollee to a PCP and notify the Enrollee and the assigned PCP in writing no later than forty (40) calendar days after the Enrollee’s coverage date. 2.10.4.2. If an Enrollee does not select a PCP within thirty (30) calendar days of the effective date of coverage date, Contractor shall use FFS utilization data or other data sources, including electronic data, to: 2.10.4.2.1. Establish existing provider relationships for the purpose of PCP assignment, including a specialist or clinic if an Enrollee indicates a preference for either. Contractor shall comply with all federal and state privacy laws in the provision and use of this data. 2.10.4.3. Contractor shall notify the PCP that an Enrollee has selected or been assigned to the PCP within ten (10) calendar days from when selection or assignment is completed by the Enrollee or the Contractor, respectively. 2.10.4.4. Contractor shall maintain procedures that proportionately include contracting traditional and safety-net providers in the assignment process for Enrollees who do not choose a PCP. 2.10.4.5. If, at any time, an Enrollee notifies the Contractor of a PCP choice, such choice shall override Enrollee assignment to a PCP.
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PCP Assignment. If the contractor has not received an enrollee's PCP selection within ten (10) calendar days from the enrollee's effective date of coverage or the selected PCP's panel is closed, the contractor shall assign a PCP and deliver an ID card by the fifteenth (15th) calendar day after the effective date of enrollment. The assignment shall be made according to the following criteria, in hierarchical order: 1. The enrollee shall be assigned to his/her current provider, if known, as long as that provider is a part of the contractor's provider network. 2. The enrollee shall be assigned to a PCP whose office is within the travel time/distance standards, as defined in Article 4.8.
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PCP Assignment. The term “PCP Assignment” refers to the process by which an HPSM Member is assigned by HPSM to a PCP for provision of certain Covered Services, or to the PCP assigned for a particular HPSM Member.
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PCP Assignment. If the contractor has not received an enrollee's PCP selection within ten (10) calendar days from the enrollee's effective date of coverage or the selected PCP's panel is closed, the contractor shall assign a PCP and deliver an ID card by the fifteenth (15th) calendar day after the effective date of enrollment. The assignment shall be made according to the following criteria, in hierarchical order: 1. The enrollee shall be assigned to his/her current provider, if known, as long as that provider is a part of the contractor's provider network. 2. The enrollee shall be assigned to a PCP whose office is within the travel time/distance standards, as defined in Article 4.8.8. If the language and/or cultural needs of the enrollee are known to the contractor, the enrollee shall be assigned to a PCP who is or has office staff who are linguistically and culturally competent to communicate with the enrollee or have the ability to interpret in the provision of health care services and related activities during the enrollee's office visits or contacts.
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PCP Assignment. Provider Network...............................................................................
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PCP Assignment. If the contractor has not received an enrollee’s PCP selection within ten (10) calendar days from the enrollee’s effective date of coverage or the selected PCP’s panel is closed, the contractor shall assign a PCP and deliver an ID card by the fifteenth (15th) calendar day after the effective date of enrollment. The assignment shall be made according to the following criteria, in hierarchical order:
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PCP Assignment. ‌ The CHC-MCO must provide a file through the Department to (PROMISe™) of PCP assignments for all its Participants.‌ The CHC-MCO must provide this file at least weekly or more frequently if requested by the Department. The CHC-MCO must ensure that the PCP assignment information is consistent with all requirements specified by the Department by utilizing the response report provided by the Department. The CHC-MCO must use this report to reconcile and correct any errors. Information on the PCP file submission is available on the Intranet supporting CHC.‌
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Related to PCP Assignment

  • Shift Assignment Should the University elect to establish a shift on any other schedule than the regular day shift (Monday through Friday) or to assign employees to work on any such shift, the employee(s) with the most seniority in the classification affected or to be assigned on such shift shall have preference in moving to such shift. If an insufficient number of employees in the classification elect to move to such shift, then the employee(s) with the least seniority in the classification shall be assigned to such shift. If positions or shifts are reduced or eliminated or movement of personnel to other shifts is required, then the seniority of the affected employee will prevail in the selection of shift, provided the affected employee can do the required work. Such shift preference is only applicable within the employee's classification.

  • SUBLET/ASSIGNMENT The Lessee may not transfer or assign this Lease, or any right or interest hereunder or sublet said leased Premises or any part thereof without first obtaining the prior written consent and approval of the Lessor.

  • Deed; Xxxx of Sale; Assignment To the extent required and permitted by applicable law, this Agreement shall also constitute a “deed,” “xxxx of sale” or “assignment” of the assets and interests referenced herein.

  • Non-Assignment PROVIDER shall neither assign its rights nor delegate its duties under this Agreement without the prior written consent of A&M System.

  • Transfer/Assignment (A) Subject to compliance with clause (B) of this Section 7, this Warrant and all rights hereunder are transferable, in whole or in part, upon the books of the Company by the registered holder hereof in person or by duly authorized attorney, and a new warrant shall be made and delivered by the Company, of the same tenor and date as this Warrant but registered in the name of one or more transferees, upon surrender of this Warrant, duly endorsed, to the office or agency of the Company described in Section 3. All expenses (other than stock transfer taxes) and other charges payable in connection with the preparation, execution and delivery of the new warrants pursuant to this Section 7 shall be paid by the Company. (B) The transfer of the Warrant and the Shares issued upon exercise of the Warrant are subject to the restrictions set forth in Section 4.4 of the Purchase Agreement. If and for so long as required by the Purchase Agreement, this Warrant shall contain the legends as set forth in Section 4.2(a) of the Purchase Agreement.

  • Contract Assignment You cannot assign this contract to another person nor sublet any part of the premises.

  • Void Assignment Any sale, exchange or other transfer by any Member of any Units or other interests in the Company in contravention of this Agreement shall be void and ineffectual and shall not bind or be recognized by the Company or any other party.

  • Work Assignment 8.1 The jurisdiction of the Unions shall be that jurisdiction established by Agreements between International Unions claiming the work or Decisions of Record recognized by the AFL-CIO for the various classifications and the character of work performed, having regard for the special requirements of thermal, nuclear or hydraulic generation and transmission and transformation construction. An Agreement or Decision of Record is one that is published by the Building and Construction Trades Department, AFL-CIO (Agreement and Decisions Rendered Affecting the Building Industry). Where no Decision or Agreement applies, the Employer agrees to consider evidence of established practices within the industry when making jurisdictional assignments. (a) A markup process will be utilized when an Employer intends to perform work on a project site*. The purpose of this markup process is to indicate to the Union the work which is planned to be carried out by the Employer in order to minimize the potential for jurisdictional disputes. (b) When work is to be performed on a project site and it meets the following criteria: same employer, same work, same project site, the markup process will not be required. This procedure shall not preclude a Union’s right to contest previously disputed work. * For the purposes of this Article, Nanticoke, Lambton, Lakeview/Xxxxx, BNPD, Pickering, Darlington, Lines and Stations and the 5 Electricity Production Zones are each considered individual project sites. In the Electricity Production Zones when work falls within this criteria the EPSCA Office will send out a “Notification of Work” along with a copy of the original minutes of xxxx-up meeting(s) to the Local Union prior to work commencing. This procedure shall not preclude the Union’s right to contest previously assigned work, if the work is in a Local Union jurisdiction other than the one it was marked up in. (c) When an Employer has work that is less than 3 weeks duration and there are ten (10) or fewer employees covered by EPSCA Collective Agreements employed on this specific work, the Union and Union affiliates will be notified of the scope of work and the Employer’s proposed work assignments. The Unions will have two (2) weeks from the date of notification to submit jurisdictional claims and supporting evidence to the Employer for consideration. The Employer will notify the Union of the final work assignments prior to the commencement of the work. (d) All work that does not meet the criteria set out in clauses 8.2(b) or 8.2(c) will be reviewed and assigned at a markup meeting. (e) EPSCA will provide written notice to the Union as far in advance as possible of markup meetings. The Unions may attend these markup meetings, and every effort will be made to settle questions of jurisdiction before the work is expected to commence. (f) The Employer who has the responsibility for the work shall make a proposed assignment of the work involved. The Employer shall be responsible for providing copies of proposed assignments to the Union at the markup meeting. The Employer will specify a reasonable time limit for the Unions involved to submit evidence of their claims. The Employer will evaluate all evidence submitted and make a final assignment of the work involved. This final assignment will be in accordance with the procedural rules established by the Plan for the Settlement of Jurisdictional Disputes in the Construction Industry. The Employer will advise the Unions of the final assignments prior to the work commencing. (g) The EPSCA representative will record the proposed assignments and jurisdictional claims and forward a copy of them within fifteen (15) working days to the Union. (h) The parties recognize that circumstances may arise, particularly with discovery and emergency work, where the process set out above may not be practical or possible, however reasonable effort will be made by the Employer to adhere to the appropriate trade jurisdiction.

  • Room Assignment The Landlord will assign rooms in accordance with the current assignment practice set by Residence Services. The Landlord reserves the right to transfer or move Tenants when deemed necessary. Tenants failing to arrive within 48 hours of the specified move-in date, without informing Residence Services of the delay, will lose their room assignment.

  • Shift Assignments When an opening occurs in a shift assignment in an appropriate work group at a location, preference shall be given to employees within the classification who possess the training, ability and any required special qualifications to perform the work required, on the basis of seniority. In the event that no employee desires a shift assignment, employees shall be selected in order of inverse seniority. This provision shall not apply to necessary training assignments. This provision shall not in itself alter the practice of rotating shifts where such practice presently exists. No employee who has a regular shift assignment on the effective date of the Agreement shall be involuntarily displaced from such shift assignment as a result of this Article.

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