Provision of Certain Claims Data and Beneficiary Reports Sample Clauses

Provision of Certain Claims Data and Beneficiary Reports. A. CMS believes that the health care operations work of the ACO (that is acting on its own behalf as a HIPAA covered entity (CE) or that is a business associate (BA) acting on behalf of its Participant Providers or Preferred Providers that are HIPAA CEs) would benefit from the receipt of certain beneficiary- identifiable data on REACH Beneficiaries and Beneficiaries who have been excluded from alignment to the ACO, including Originally Aligned Beneficiaries. CMS will therefore offer to the ACO an opportunity to request specific Beneficiary-identifiable data by completing the HIPAA-Covered Data Disclosure Request Form. This data set will not include SUD data; however, CMS will notify the ACO in writing if CMS subsequently elects to offer the ACO an opportunity to request Beneficiary-identifiable SUD data by completing the HIPAA-Covered Data Disclosure Request Form. All requests for Beneficiary- identifiable claims data will be granted or denied at CMS’ sole discretion based on CMS’s available resources and technological capabilities, the limitations in the Agreement, and applicable law.
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Provision of Certain Claims Data and Beneficiary Reports. A. CMS believes that the health care operations work of the DCE (that is acting on its own behalf as a HIPAA covered entity (CE) or that is a business associate (BA) acting on behalf of its DC Participant Providers or Preferred Providers that are HIPAA CEs) would benefit from the receipt of certain beneficiary-identifiable claims data on Originally Aligned Beneficiaries and DC Beneficiaries. CMS will therefore offer to the DCE an opportunity to request specific Beneficiary- identifiable data by completing the HIPAA-Covered Data Disclosure Request Form. This data set will not include substance use disorder data; however, CMS will notify the DCE in writing if CMS subsequently elects to offer the DCE an opportunity to request Beneficiary-identifiable substance use disorder data by completing the HIPAA-Covered Data Disclosure Request Form. All requests for Beneficiary-identifiable claims data will be granted or denied at CMS' sole discretion based on CMS' available resources and technological capabilities, the limitations in the Agreement, and applicable law.
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Provision of Certain Claims Data and Beneficiary Reports. 58 Section 6.03 De-Identified Reports 64 Section 6.04 Beneficiary Rights to Opt Out of Data Sharing 64
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Provision of Certain Claims Data and Beneficiary Reports 
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Related to Provision of Certain Claims Data and Beneficiary Reports

  • Obligation to Provide State Access to Grant Records The Grantee must make all grant records of expenditures, copies of reports, books, and related documentation available to the Division or a duly authorized representative of the State of Florida for inspection at reasonable times for the purpose of making audits, examinations, excerpts and transcripts.

  • Certification of claims by Statutory Auditors Any claim or document provided by the Concessionaire to the Authority in connection with or relating to receipts, income, payments, costs, expenses, accounts or audit, and any matter incidental thereto shall be valid and effective only if certified by its Statutory Auditors. For the avoidance of doubt, such certification shall not be required for exchange of information in the normal course of business including the submission of Monthly Fee Statements under Clause 19.5.

  • Certification of Funds; Budget and Fiscal Provisions; Termination in the Event of Non-Appropriation This Agreement is subject to the budget and fiscal provisions of the City’s Charter. Charges will accrue only after prior written authorization certified by the Controller, and the amount of City’s obligation hereunder shall not at any time exceed the amount certified for the purpose and period stated in such advance authorization. This Agreement will terminate without penalty, liability or expense of any kind to City at the end of any fiscal year if funds are not appropriated for the next succeeding fiscal year. If funds are appropriated for a portion of the fiscal year, this Agreement will terminate, without penalty, liability or expense of any kind at the end of the term for which funds are appropriated. City has no obligation to make appropriations for this Agreement in lieu of appropriations for new or other agreements. City budget decisions are subject to the discretion of the Mayor and the Board of Supervisors. Contractor’s assumption of risk of possible non-appropriation is part of the consideration for this Agreement. THIS SECTION CONTROLS AGAINST ANY AND ALL OTHER PROVISIONS OF THIS AGREEMENT.

  • PERSONAL INJURY BENEFITS A. 1. Whenever a teacher is absent from duty as a result of personal injury caused by an accident or an assault and/or battery upon the teacher arising out of and in the course of employment, the teacher will be paid full salary (less the amount of any worker's compensation paid for said injury) for the period of such absence not to exceed 189 working days.

  • Payment of Paid Personal/Carer’s Leave (a) If an employee takes a period of paid personal/xxxxx’s leave and meets the notice requirements set out at Clause 44.3 the employer must pay the employee at the employee’s base rate of pay for the employee’s ordinary hours of work in the period.

  • Retention of Records, Right to Monitor and Audit (a) CONTRACTOR shall maintain all required records for three (3) years after the COUNTY makes final payment and all other pending matters are closed, and shall be subject to the examination and/or audit of the County, a Federal grantor agency, and the State of California.

  • Notification of Claims In order that the indemnification provisions contained in this Section shall apply, upon the assertion of a claim for which either party may be required to indemnify the other, the party seeking indemnification shall promptly notify the other party of such assertion, and shall keep the other party advised with respect to all developments concerning such claim. The party who may be required to indemnify shall have the option to participate with the party seeking indemnification in the defense of such claim or to defend against said claim in its own name or in the name of the other party. The party seeking indemnification shall in no case confess any claim or make any compromise in any case in which the other party may be required to indemnify it except with the other party’s prior written consent.

  • Special Claims Made Policy Form Provisions CONTRACTOR shall not provide a Commercial General Liability (Claims Made) policy without the express prior written consent of COUNTY, which consent, if given, shall be subject to the following conditions:

  • Electronic Posting of Notice of Intended Award Based on the evaluation, on the date indicated in the Timeline of Events the Department shall electronically post a Notice of Intended Award on the VBS and the MFMP Sourcing website for review by interested parties at the time and location specified in the Timeline of Events. The Notice of Intended Award shall remain posted for a period of seventy-two (72) hours, not including weekends or State observed holidays. If the notice of award is delayed, in lieu of posting the notice of intended award the Department may post a notice of the delay and a revised date for posting the notice of intended award.

  • IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC TRANSFERS In the event that you believe there has been an error with respect to any original check or image thereof transmitted to the Credit Union for deposit or a breach of this Agreement and Disclosure, you will immediately contact the Credit Union regarding such error or breach as set forth below. • By calling the Credit Union at: 000-000-0000; • By emailing the Credit Union at: xxxxxxxxxx@xxxxxxxxxxx.xxx; or • By writing a letter and sending it to P.O. Box 60890, Los Angeles, CA 00000-0000. Contact us as soon as you can if you think your statement or receipt is wrong or if you need more information about a transfer listed on the statement or receipt. We must hear from you no later than 60 days after we sent the FIRST statement on which the problem or error appeared. • Tell us your name and Account number. • Describe the error or the transfer you are unsure about, and explain as clearly as you can why you believe it is an error or why you need more information. • Tell us the dollar amount of the suspected error. If you tell us orally, we may require that you send us your complaint or question in writing within ten (10) business days. We will tell you the results of our investigation within ten (10)* business days after we hear from you and will correct any error promptly. If we need more time, however, we may take up to 45** days to investigate your complaint or question. If we decide to do this, we will provisionally credit your Account within ten (10)* business days for the amount you think is in error, so that you will have the use of the money during the time it takes us to complete our investigation. If we ask you to put your complaint or question in writing and we do not receive it within ten (10) business days, we may not credit your Account. If we decide that there was no error, we will send you a written explanation within three (3) business days after we finish our investigation. You may ask for copies of the documents that we used in our investigation. * If you assert an error within 30 days after you make the first deposit to your Account, we will have 20 business days instead of ten (10) business days. ** If you give notice of an error within 30 days after you make the first deposit to your Account, or notice of an error involving a transaction initiated outside the United States, its possessions and territories, we will have 90 days instead of 45 days to investigate. In accordance with Visa Operating Rules and Regulations, you will receive a provisional credit for Visa Check Card losses for unauthorized use within five (5) business days after you have notified us of the loss. This does not apply to ATM transactions using a PIN(s).

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