Primary Care Network List Sample Clauses

Primary Care Network List. (1) The MCO must supply all Local Agencies within its Service Area with copies of a standardized document (known as a Primary Care Network List, or PCNL) that provides information about the MCO’s Medicare and Medicaid Provider network and that includes a description of the essential components of the MCO, to be used by the Local Agencies to educate consumers. This document must follow the STATE specification as indicated in the STATE document “PCNL Guidelines,” and must be Prior Approved by the STATE in accordance with section 3.2.4(B). The document must be printed on a grade of paper that is equivalent to bond paper that is not less than nineteen (19) pound bond but not greater than twenty (20) pound bond. If the PCNL has a cover, the grade of paper may be on un-coated offset paper or on glossy paper. The paper must be 8 ½" x 11" or 17" x 11". A 17" x 11" document must fold to 8 ½" x 11". The document must contain the following information:
Sample 1Sample 2
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Primary Care Network List. (PCNL).‌
Sample 1
Primary Care Network List. When the HEALTH PLAN is new to a Service Area, the HEALTH PLAN must supply the Local Agency, and the STATE for MinnesotaCare, with a supply of the final, printed and approved Primary Care Network List 10 calendar days in advance of the Education Begin Date and on or before the first day of each calendar quarter thereafter, in quantities sufficient to meet the Local Agency or STATE need for a calendar quarter. If the HEALTH PLAN’s Service Area expands for MinnesotaCare, additional Primary Care Network Lists must be supplied to the STATE 60 days prior to the effective date of the expanded Service Area. The HEALTH PLAN must update the Primary Care Network List as necessary to maintain accuracy, particularly with regard to the list of Participating Providers. The Primary Care Network List and all revisions to the Primary Care Network List must be approved in writing by the STATE before copies are provided to the Local Agency. Such approval by the STATE shall not be unreasonably withheld.
Sample 1

Related to Primary Care Network List

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  • Provider Network The Panel of health service Providers with which the Contractor contracts for the provision of covered services to Members and Out-of-network Providers administering services to Members.

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  • Emergency and urgently needed care outside the service area Professional services of a physician, emergency room treatment, and inpatient hospital services are covered at eighty percent (80%) of the first two thousand dollars ($2,000) of the charges incurred per insurance year, and one-hundred percent (100%) thereafter. The maximum eligible out-of-pocket expense per individual per year for this benefit is four hundred dollars ($400). This benefit is not available when the member’s condition permits him or her to receive care within the network of the plan in which the individual is enrolled.

  • Information Services Traffic 5.1 For purposes of this Section 5, Voice Information Services and Voice Information Services Traffic refer to switched voice traffic, delivered to information service providers who offer recorded voice announcement information or open vocal discussion programs to the general public. Voice Information Services Traffic does not include any form of Internet Traffic. Voice Information Services Traffic also does not include 555 traffic or similar traffic with AIN service interfaces, which traffic shall be subject to separate arrangements between the Parties. Voice Information services Traffic is not subject to Reciprocal Compensation as Local Traffic under the Interconnection Attachment.

  • Urgent Care Services All Medically Necessary Covered Services received in Urgent Care Centers, Retail Clinics or your Primary Care Physician’s office after-hours to treat an Urgent Medical Condition will be covered by AvMed. Any request for reimbursement of payment made by a Member for services received must be filed within 90 days or as soon as reasonably possible but not later than one year unless the Member was legally incapacitated. If Urgent Medical Services and Care are required while outside the continental United States, Alaska or Hawaii, it is the Member’s responsibility to pay for such services at the time they are received. For information on filing a Claim for such services, see Part XIII. REVIEW PROCEDURES AND HOW TO APPEAL A CLAIM (BENEFIT) DENIAL.

  • AIN Selective Carrier Routing for Operator Services, Directory Assistance and Repair Centers 4.3.1 BellSouth will provide AIN Selective Carrier Routing at the request of <<customer_name>>. AIN Selective Carrier Routing will provide <<customer_name>> with the capability of routing operator calls, 0+ and 0- and 0+ NPA (LNPA) 555-1212 directory assistance, 1+411 directory assistance and 611 repair center calls to pre-selected destinations.

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  • Customer Assistance If any job requires that any aspect of the Services, such as Code implementation, be performed on Customer’s premises, Customer will supply Tealium personnel with such information, resources, and assistance as Tealium may reasonably request. Customer acknowledges and agrees that Tealium’s ability to successfully provide the Services in a timely manner is contingent upon its timely receipt from Customer of such information, resources and assistance as may be reasonably requested by Tealium. Tealium will have no liability for deficiencies or delays in the Services resulting from the acts or omissions of Customer, its agents, or employees or performance of the Services in accordance with Customer’s instructions. Without limiting the foregoing, Customer acknowledges and agrees that if Tealium is unable to deploy all of the Services specified in the Service Order as a result of delay attributable to Customer, then all set-up fees specified in the Service Order will be deemed earned by Tealium and payable by Customer, notwithstanding such delay in deployment.

  • Office of Supplier Diversity The State of Florida supports its diverse business community by creating opportunities for woman-, veteran-, and minority-owned small business enterprises to participate in procurements and contracts. The Department encourages supplier diversity through certification of woman-, veteran-, and minority-owned small business enterprises and provides advocacy, outreach, and networking through regional business events. For additional information, please contact the Office of Supplier Diversity (OSD) at xxxxxxx@xxx.xxxxxxxxx.xxx.

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