PLANNED ADMISSION Sample Clauses

The Planned Admission clause defines the procedures and requirements for hospital admissions that are scheduled in advance, rather than those arising from emergencies. Typically, this clause outlines the need for prior authorization from the insurer or healthcare provider, specifies any necessary documentation, and may set timeframes for notification before the admission occurs. Its core function is to ensure that all parties are informed and prepared for the admission, helping to manage costs, coordinate care, and prevent disputes over coverage or payment.
PLANNED ADMISSION. It is agreed between the parties that on receipt of request for hospitalization on behalf of the beneficiary the process to be followed by the hospital is prescribed in Annexure I.
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PLANNED ADMISSION. 4.1 Request for hospitalisation on behalf of the benefic iary may be made by the hospital provider / consultant attached to the provider /benefic iary himself after obtaining due details form treating doctor in the prescribed format as per the Annexure-A. The prescribed format needs to be faxed to the 24 hr help desk at ▇▇▇▇▇ ▇▇▇▇▇▇▇ telephone number /contact details of treating physic ian and the benefic iary needs to be mentioned as it would ease the process in the cases where the symptoms are vague, no effective diagnosis is arrived at, the medic al team of ▇▇▇▇▇ ▇▇▇▇▇▇▇ would get in touch with treating physic ian /benefic iary if necessary. 4.2 ▇▇▇▇▇ ▇▇▇▇▇▇▇ guarantees payment only after receipt of intimation and the necessary medic al details and after it has ascertained the eligibility of coverage and issued the Preauthorisation. 4.3 In case the ailment is not covered or given medic al data is not suffic ient for the medic al team of helpdesk to confirm the eligibility, ▇▇▇▇▇ ▇▇▇▇▇▇▇ can deny the guarantee of payment whic h shall be addressed to the Insured. The provider will have to follow their normal practic e in such case. 4.4 Denial of Authorisation/guarantee of payment in no way means denial of treatment. The provider is requested to deal with each case as per their normal rules and regulations. 4.5 Authorisation certificate will mention the amount guaranteed class of admission, eligibility of benefic iary or various sub limits for rooms & board, surgical fees etc. wherever applicable. As per the benefit plan of the insured. Provider must see that these rules are strictly followed. 4.6 The guarantee of payment is given only for the necessary treatment cost of the ailment covered and mentioned in the request for hospitalisation. Non covered item like Telephone usage, relative food, hospital registration fees etc. must be collected directly from the insured Any Investigation carried out at the request of the patient but not forming the necessary part of the treatment also must be collected from the patient. 4.7 The Authorisation certificate normally mentions the amount whic h is requested at the time of request for hospitalisation or the total sum available. Therefore, in event of cost of treatment going above the guaranteed amount the provider may check the availability of further limit with ▇▇▇▇▇ ▇▇▇▇▇▇▇. 4.8 Primary responsibility of obtaining Authorisation letter would be of the policyholder and Hospitals/Provider could only assist if require...
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PLANNED ADMISSION. 4.1 Request for hospitalization on behalf of the beneficiary may be forwarded by the provider/consultant attached to the provider, or beneficiary himself after obtaining due details from the treating doctor in the prescribed format i.e. “Request For Authorisation Letter” (RAL). The RAL needs to be faxed to the 24-hour Authorisation /Cashless Department at MDIndia Healthcare Services (P) Ltd. Head Office, Pune Telephone number/ contact details of treating physician and the beneficiary needs to be mentioned, as it would ease the process. The medical team of MDIndia would get in touch with treating physician / beneficiary, if necessary.
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PLANNED ADMISSION i. Request for admission on behalf of the Member may be made by the Service Provider or Consultant attached to the Service Provider as per the prescribed format. The Pre- Authorization form needs to give the details of the Member's proposed admission along with the necessary medical details and the treatment planned to be administered and the breakup of the estimated cost in accordance with Schedule I, attached herein.
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PLANNED ADMISSION. 4.1 The beneficiary of the NIT, Jalandhar will be allowed admission only after obtaining the referral slip from the institute except in case of emergency in which the confirmation/authorization of the patient has to be obtained by the provider within three days or prior to discharge whichever is earlier. In case of Drink and Drug abuse reimbursement will not be allowed.
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Related to PLANNED ADMISSION

  • Investigatory Interview When the employee under investigation is to be interviewed concerning the alleged conduct which could result in discharge or other discipline, the employee and his or her representative shall be notified in writing, at least forty-eight (48) hours prior to the interview. In the event of an emergency, such reasonable notice as the circumstances permit shall be given. The notice shall state that an official investigation is being conducted and shall state the subject matter of the investigatory interview. a. Prior to being interviewed pursuant to this section, the employee shall be afforded a reasonable opportunity and facilities to contact and consult privately with his or her union representative or union attorney. b. Any interview of an employee under this section shall be conducted at a reasonable time, at a suitable location and, when practicable, on the department’s premises when the employee is on duty. The union representative or union attorney may participate in the interview. c. The interview shall be limited to questions that are directly, narrowly, and specifically related to the employee’s job performance as it relates to the allegation(s) or complaints. The employee shall not be subjected to any offensive language nor be threatened with transfer, dismissal or other disciplinary action. Confidentiality of the interview shall be maintained.

  • Investigatory Interviews ‌ A. Upon request, an employee has the right to a union representative at an investigatory interview called by the Employer, if the employee reasonably believes discipline could result. An employee may also have a union representative at a pre-disciplinary meeting. If the requested representative is not reasonably available, the employee will select another representative who is available. Employees seeking representation are responsible for contacting their representative.

  • Procurement Related Complaints and Administrative Review 49.1 The procedures for making a Procurement-related Complaint are as specified in the TDS. 49.2 A request for administrative review shall be made in the form provided under contract forms.

  • Search, Enquiry, Investigation, Examination And Verification a. The Property is sold on an “as is where is basis” subject to all the necessary inspection, search (including but not limited to the status of title), enquiry (including but not limited to the terms of consent to transfer and/or assignment and outstanding charges), investigation, examination and verification of which the Purchaser is already advised to conduct prior to the auction and which the Purchaser warrants to the Assignee has been conducted by the Purchaser’s independent legal advisors at the time of execution of the Memorandum. b. The intending bidder or the Purchaser is responsible at own costs and expenses to make and shall be deemed to have carried out own search, enquiry, investigation, examination and verification on all liabilities and encumbrances affecting the Property, the title particulars as well as the accuracy and correctness of the particulars and information provided. c. The Purchaser shall be deemed to purchase the Property in all respects subject thereto and shall also be deemed to have full knowledge of the state and condition of the Property regardless of whether or not the said search, enquiry, investigation, examination and verification have been conducted. d. The Purchaser shall be deemed to have read, understood and accepted these Conditions of Sale prior to the auction and to have knowledge of all matters which would have been disclosed thereby and the Purchaser expressly warrants to the Assignee that the Purchaser has sought independent legal advice on all matters pertaining to this sale and has been advised by his/her/its independent legal advisor of the effect of all the Conditions of Sale. e. Neither the Assignee nor the Auctioneer shall be required or bound to inform the Purchaser of any such matters whether known to them or not and the Purchaser shall raise no enquiry, requisition or objection thereon or thereto.

  • Errors, Questions, and Complaints a. In case of errors or questions about your transactions, you should as soon as possible contact us as set forth in Section 6 of the General Terms above. b. If you think your periodic statement for your account is incorrect or you need more information about a transaction listed in the periodic statement for your account, we must hear from you no later than sixty (60) days after we send you the applicable periodic statement for your account that identifies the error. You must: 1. Tell us your name; 2. Describe the error or the transaction in question, and explain as clearly as possible why you believe it is an error or why you need more information; and, 3. Tell us the dollar amount of the suspected error. c. If you tell us orally, we may require that you send your complaint in writing within ten (10) Business Days after your oral notification. Except as described below, we will determine whether an error occurred within ten (10) Business Days after you notify us of the error. We will tell you the results of our investigation within three (3) Business Days after we complete our investigation of the error, and will correct any error promptly. However, if we require more time to confirm the nature of your complaint or question, we reserve the right to take up to forty-five (45) days to complete our investigation. If we decide to do this, we will provisionally credit your Eligible Transaction Account within ten (10) Business Days for the amount you think is in error. If we ask you to submit your complaint or question in writing and we do not receive it within ten (10) Business Days, we may not provisionally credit your Eligible Transaction Account. If it is determined there was no error we will mail you a written explanation within three (3) Business Days after completion of our investigation. You may ask for copies of documents used in our investigation. We may revoke any provisional credit provided to you if we find an error did not occur.