Qualifying Diagnosis Sample Clauses

Qualifying Diagnosis. A Qualifying Diagnosis is a diagnosis by a Licensed Medical Provider that a Class Member presently has (or had in the past during or after his or her work as a Content Moderator for a Facebook Vendor) one of the following disorders: (a) Post-Traumatic Stress Disorder (including ICD-10 43.1, 43.10, 43.11, and 43.12); (b) Acute Stress Disorder (including ICD-10 43.0); (c) Other/Unspecified Trauma- or Stress- Related Disorder (including ICD-10 43.8 and 43.9); (d) Anxiety Disorder (including ICD- 10 41.0, 41.1, 41.3, 41.8, and 41.9); or (e) Depression (including ICD-10 32 and 33).
Sample 1
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Qualifying Diagnosis. The IHH Provider shall confirm that each member in the provider’s health home has a diagnosis that makes the member eligible for IHH services and document proof of that diagnosis in the member’s health records before billing IHH service to the member. For IHH services, the only diagnoses that qualify a member for services are Serious Mental Illness (“SMI”) that causes serious functional impairment and substantially interferes with or limits one or more major life activities including functioning in the family, school, employment or community in an adult or Serious Emotional Disturbance (“SED”) which resulted in functional impairment that substantially interferes with or limits the child’s role or functioning in family, school, or community activities. SED may co- occur with substance use disorder, developmental, neurodevelopmental or intellectual disabilities but those diagnoses may not be the clinical focus for health home xxxxxxxx.xx a person under the age 18, as such terms are defined in the then current State Plan Amendment authorizing the state to provide health home services.
Sample 1
Qualifying Diagnosis a) Before billing for CCHH service to the member, the CCHH Provider shall o Confirm that the member has an eligible chronic condition diagnosis and is at risk for developing another, which combination makes the member eligible for CCHH services; and o Document in the member’s health records the chronic condition diagnosis, the chronic condition that the member is at risk of developing, and the criteria identified in subsection (c) on which the determination that the member is at risk has been made.
Sample 1
Qualifying Diagnosis. Individuals must possess one or more of the qualifying Diagnoses approved for 1915(i) eligibility. The list of approved diagnoses are on the 1915(i) Eligibility Form. Responsibilities of the 1915(i) Eligibility Worker
Sample 1

Related to Qualifying Diagnosis

  • Diagnosis For a condition to be considered a covered illness or disorder, copies of laboratory tests results, X-rays, or any other report or result of clinical examinations on which the diagnosis was based, are required as part of the positive diagnosis by a physician.

  • QUALIFYING USE The Applicant’s Qualified Property described in Section 3.3 qualifies for a tax limitation agreement under Section 313.024(b)(5) of the TEXAS TAX CODE as a renewable energy electric generation facility.

  • Qualifying Events In order to be eligible for COBRA continuation, you need to have experienced a Qualifying Event. A Qualifying Event is one of the events listed below which would result in loss of coverage if not for the COBRA continuation:

  • Human Leukocyte Antigen Testing This plan covers human leukocyte antigen testing for A, B, and DR antigens once per member per lifetime to establish a member’s bone marrow transplantation donor suitability in accordance with R.I. General Law §27-20-36. The testing must be performed in a facility that is: • accredited by the American Association of Blood Banks or its successors; and • licensed under the Clinical Laboratory Improvement Act as it may be amended from time to time. At the time of testing, the person being tested must complete and sign an informed consent form that also authorizes the results of the test to be used for participation in the National Marrow Donor program.

  • Qualifying Period If a regular employee is promoted or transferred to a position, then that employee shall be considered a qualifying employee in her new position for a period of ninety (90) calendar days. If a regular employee is promoted or transferred to a position either within or outside the certification and is found to be unsatisfactory, she shall be returned to her previously held position. If a regular employee is promoted to a position, either within or outside the certification, and finds the position to be unsatisfactory, she shall be returned to her previously held position.

  • CHILD AND DEPENDENT ADULT/ELDER ABUSE REPORTING CONTRACTOR shall establish a procedure acceptable to ADMINISTRATOR to ensure that all employees, agents, subcontractors, and all other individuals performing services under this Agreement report child abuse or neglect to one of the agencies specified in Penal Code Section 11165.9 and dependent adult or elder abuse as defined in Section 15610.07 of the WIC to one of the agencies specified in WIC Section 15630. CONTRACTOR shall require such employees, agents, subcontractors, and all other individuals performing services under this Agreement to sign a statement acknowledging the child abuse reporting requirements set forth in Sections 11166 and 11166.05 of the Penal Code and the dependent adult and elder abuse reporting requirements, as set forth in Section 15630 of the WIC, and shall comply with the provisions of these code sections, as they now exist or as they may hereafter be amended.

  • Qualifying Exigency Leave In the event that a member of the employee’s immediate household is called to covered active duty, such as a short notice deployment (i.e., deployment within seven or less days of notice), the employee will be granted time off to address necessary family matters in accordance with the Family and Medical Leave Act (FMLA).

  • Employees with a Work-related Injury/Disability An employee who was off the State payroll due to a work-related injury or a work-related disability may continue to participate in the Group Insurance Program as long as such an employee receives workers' compensation payments or while the workers' compensation claim is pending.

  • How to File an Appeal of a Prescription Drug Denial For denials of a prescription drug claim based on our determination that the service was not medically necessary or appropriate, or that the service was experimental or investigational, you may request an appeal without first submitting a request for reconsideration. You or your physician may file a written or verbal prescription drug appeal with our pharmacy benefits manager (PBM). The prescription drug appeal must be submitted to us within one hundred and eighty (180) calendar days of the initial determination letter. You will receive written notification of our determination within thirty (30) calendar days from the receipt of your appeal. How to File an Expedited Appeal Your appeal may require immediate action if a delay in treatment could seriously jeopardize your health or your ability to regain maximum function, or would cause you severe pain. To request an expedited appeal of a denial related to services that have not yet been rendered (a preauthorization review) or for on-going services (a concurrent review), you or your healthcare provider should call: • our Grievance and Appeals Unit; or • our pharmacy benefits manager for a prescription drug appeal. Please see Section 9 for contact information. You will be notified of our decision no later than seventy-two (72) hours after our receipt of the request. You may not request an expedited review of covered healthcare services already received.

  • STATEWIDE ACHIEVEMENT TESTING When CONTRACTOR is an NPS, per implementation of Senate Bill 484, CONTRACTOR shall administer all Statewide assessments within the California Assessment of Student Performance and Progress (“CAASP”), Desired Results Developmental Profile (“DRDP”), California Alternative Assessment (“CAA”), achievement and abilities tests (using LEA-authorized assessment instruments), the Fitness Gram with the exception of the English Language Proficiency Assessments for California (“ELPAC”) to be completed by the LEA, and as appropriate to the student, and mandated by XXX xxxxxxxx to LEA and state and federal guidelines. CONTRACTOR is subject to the alternative accountability system developed pursuant to Education Code section 52052, in the same manner as public schools. Each LEA student placed with CONTRACTOR by the LEA shall be tested by qualified staff of CONTRACTOR in accordance with that accountability program. XXX shall provide test administration training to CONTRACTOR’S qualified staff. CONTRACTOR shall attend LEA test training and comply with completion of all coding requirements as required by XXX.

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