Pre-Authorization Sample Clauses
Pre-Authorization. Certain services and supplies under this Certificate may require pre-authorization by HMO to determine if they are Covered Benefits under this Certificate.
Pre-Authorization. All Extended Employment Services must be pre-authorized by an Extended Employment Services Program specialist, and shall be set forth in the Individual Program Plan for each Client. (3-14-07) 03. Billing Procedures. (3-14-07)
a. Certified Extended Employment Services Providers must submit a monthly billing statement for each Client served, in a format approved by an Extended Employment Services Program Specialist and within timelines set forth in the annual Employment Services Provider Agreement. (3-14-07) b. Bills may only be submitted for Extended Employment Services that have been identified and accepted by IDVR, as set out in an Individual Program Plan. (3-14-07)
Pre-Authorization. Overtime work must be approved before it is performed unless the circumstances are such that the employee's uninterruptible work is required by the Court, in which case it shall be deemed approved. The employee must complete a written request to work additional hours, and submit it to the appropriate supervisor for signature. Approved written requests should be attached to the employees' monthly timesheet. Failure or refusal to work scheduled overtime or working overtime without prior authorization from the supervisor may result in disciplinary action, up to and including, termination of employment.
Pre-Authorization. 11.1 The Provider will submit the e-pre-authorization, after admitting the patient as in- patient, on the Aarogyasri Website complete in all aspects including the signed copy of consent of the Patient. All relevant test reports along with Digital photograph of the Beneficiary taken in the hospital should also be uploaded. Catheterization CD, MRI films, X-rays should be uploaded, cytology and biopsy reports / slides should be submitted.
Pre-Authorization. All EES must be pre-authorized by the EES program, and shall be set forth in the Individual Program Plan for each customer. (3-29-17)
Pre-Authorization. Company represents that all debit and credit entries have been pre-authorized and that a pre- authorization agreement is of record.
Pre-Authorization. The Contractor shall suspend the requirement for any pre-authorization of services required in the Agreement and as defined in Article 1.90. The Contractor shall also extend all existing pre-authorization of services for members. In addition, prior authorizations for medications shall be expanded by automatic renewal without clinical review, or time/quantity extensions. In the event of a drug shortage occurrence the Contractor shall cover a brand name drug product that is a multi-source drug if a generic drug option is not available.
Pre-Authorization. Upon submission of a credit, debit, or prepaid card to aGO, a $1 pre- authorization charge will be made against the card, but the charge will not be captured. This is to ensure the validity of the card and will not cause funds to be removed from the Member's bank account. The pre-authorization charge will be released within seven days.
Pre-Authorization. 11.1 Preauthorization request will be sent only after admission and the patient will be there in the hospital as inpatient till final decision on the preauthorization is made.
11.2 The Provider will submit the pre-authorization, after admitting the patient as in- patient, on the Aarogyasri Website complete in all aspects including the signed copy of consent of the Patient. All relevant test reports along with Digital photograph of the Beneficiary taken in the hospital should also be uploaded. Catheterization CD, MRI films, X-rays, biopsy reports should be uploaded. Details of medicines and other procedures for Medical Management.
11.3 Trust undertake to approve the preauthorization indicating the relevant package rates within 12 working hours of the receipt of the request for pre- authorization form as well as the required data and information online and recommend to Revenue department
11.4 The Revenue department will give the final approval for beneficiary to undergo treatment with CMRF assistance.
11.5 However, the validity of the pre-authorization is for a period of one month only and hospital need to revalidate the pre-authorization after the expiry period of one month giving valid reasons.
11.6 If the provider is not able to conduct the operation within a reasonable time for any reason other than medical such as non availability of beds or specialists, the Provider will arrange for the operation to be conducted at any other appropriate Network Hospitals in consultation with the Trust.
11.7 Trust reserves the right to disallow the claim if the Surgery/Therapy is performed before any approval from the Trust and pre-authorization is obtained at a later date keeping the Trust in the dark about the surgery/therapy without valid reason.
Pre-Authorization. 18.1 Pre-authorization request will be sent only after admission and the patient will be in the hospital as inpatient till final decision is given on the Preauthorization.
(i) The Provider will submit the e-pre-authorization after admitting the patient as in- patient on the Aarogyasri Website completely in all aspects including the signed copy of consent of the Patient.
(ii) All relevant test reports along with Digital photograph of the Beneficiary taken in the hospital should be uploaded, Catheterization CD, MRI films, X-rays, biopsy reports will be uploaded, cytology and biopsy reports / slides should be submitted by the Provider.
(iii) The Provider agrees to upload the clinical photographs as required under the scheme taking due care of confidentiality of patient and follow the standard medical practices & ethics.
18. 2a Trust/Insurer undertake to approve the Preauthorization in consultation with the panel doctors indicating the relevant package rates within 12 working hours of receipt of the request for pre-authorization form, the required data and information online.