Resolution and Notification Sample Clauses

Resolution and Notification. Basic rule. The Contractor must dispose of each grievance and resolve each appeal, and provide notice, as expeditiously as the member's health condition requires, within the timeframes established in Section 9.7.1 below.
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Resolution and Notification. 1. The Health Plan shall follow Agency guidelines in resolving grievances and appeals as expeditiously as possible, observing required timeframes and taking into account the enrollee’s health condition.
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Resolution and Notification. 2.5.5.1 The Contractor shall review each grievance and send a notice of resolution to the enrollee no later than ninety (90) calendar days from the date the Contractor receives the grievance.
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Resolution and Notification. CONTRACTOR shall resolve each appeal and provide notice to enrollee, as expeditiously as the enrollee's health condition requires, within the ADMINISTRATION's established timeframes, which may not exceed forty-five (45) days from the day the CONTRACTOR received the appeal.
Sample 1
Resolution and Notification. INSURER shall resolve each expedited appeal and provide notice, as expeditiously as the enrollee’s health condition requires, and within the ADMINISTRATION established timeframes, which may never exceed three (3) working days after the INSURER received the appeal.
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Resolution and Notification. The contractor must resolve each appeal, and provide notice, as expeditiously as the enrollee’s health condition requires, within 45 days from the day the contractor receives the appeal.
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Resolution and Notification. Basic Rule: The CCN must dispose of a grievance and provide notice, as expeditiously as the member’s health condition requires, within the timeframes established in § 9.5.3.1 below.
Sample 1
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Resolution and Notification. Grievances and Appeals (42 CFR §438.408).
Sample 1
Resolution and Notification. The contractor’s internal grievance procedure may use the timeframes provided in s. 641.511, F.S. as guidelines, unless a shorter time period is otherwise specified in this part. Standard disposition of a grievance must not exceed 90 days from the date the contractor receives the grievance, unless the enrollee requests the extension or the contractor requires additional information and the delay will not prejudice the enrollee’s interest. The extension should not exceed 14 calendar days and the contractor must provide the enrollee written notice of the reason it is requesting a delay. The contractor’s appeal process must provide for a timeframe that is no longer than 45 days from the date the appeal is received by the contractor through resolution. An extension of up to 14 days for both standard and expedited appeals, may be permitted for the same reasons as is permitted for resolution of standard grievances and as detailed in 42 CFR 438.408. The contractor must provide a method for expedited resolution of appeals as expeditiously as required by the enrollee’s condition but in any event, resolution should not exceed 3 working days after receipt of the request for appeal. If the contractor denies a request for an expedited review, it should provide for prompt oral notice of the denial to the enrollee, followed by written notice within 2 calendar days. The contractor must also provide for a transfer of the appeal to the timeframe for standard resolution of the appeal. The contractor must provide written notice of disposition of all appeals. It is recommended that the contractor provide reasonable efforts for oral notice of disposition of expedited appeals. The written notice must contain the results of the resolution process and the date it was completed. If an appeal is not resolved wholly in favor of an enrollee, the written notice must set out the enrollee’s right to request a fair hearing and the process required to make the request and the right to receive benefits while the fair hearing is pending and how to make that request. The notice should also make the enrollee aware that he or she may be held liable for the cost of those benefits if the fair hearing decision upholds the contractor’s action.
Sample 1

Related to Resolution and Notification

  • Board Notification The Fund shall provide to the Board of Trustees of the Trust (the “Board”) a quarterly report of any reimbursements paid to the Adviser pursuant to this Agreement.

  • Cooperation, Notification Each party shall, and shall cause its subsidiaries to, (i) confer on a regular and frequent basis with one or more representatives of the other party to discuss, subject to applicable law, material operational matters and the general status of its ongoing operations; (ii) promptly notify the other party of any significant changes in its business, properties, assets, condition (financial or other), results of operations or prospects; (iii) advise the other party of any change or event which has had or, insofar as reasonably can be foreseen, is reasonably likely to result in, in the case of the Company, a Company Material Adverse Effect or, in the case of Parent, a Parent Material Adverse Effect; and (iv) promptly provide the other party with copies of all filings made by such party or any of its subsidiaries with any state or federal court, administrative agency, commission or other Governmental Authority in connection with this Agreement and the transactions contemplated hereby.

  • Tax Notification The Plan is a plan to which Subdivision 83A-C of the Income Tax Assessment Xxx 0000 (Cth) applies (subject to conditions in the Act).

  • Required Notifications Each Grantor shall promptly notify the Administrative Agent, in writing, of: (i) any Lien (other than Permitted Liens) on any of the Collateral which would adversely affect the ability of the Administrative Agent to exercise any of its remedies hereunder and (ii) the occurrence of any other event which could reasonably be expected to have a material impairment on the aggregate value of the Collateral or on the security interests created hereby.

  • Resolution of Claims The Company acknowledges that a settlement or other disposition short of final judgment may be successful on the merits or otherwise for purposes of Section 8(a)(i) if it permits a party to avoid expense, delay, distraction, disruption and uncertainty. In the event that any Claim relating to an Indemnifiable Event to which Indemnitee is a party is resolved in any manner other than by adverse judgment against Indemnitee (including, without limitation, settlement of such action, claim or proceeding with our without payment of money or other consideration) it shall be presumed that Indemnitee has been successful on the merits or otherwise for purposes of Section 8(a)(i). The Company shall have the burden of proof to overcome this presumption.

  • Notification of litigation The Borrower will provide the Agent with details of any legal or administrative action involving the Borrower, any Security Party, the Approved Manager, any Ship or the Earnings or the Insurances of any Ship as soon as such action is instituted or it becomes apparent to the Borrower that it is likely to be instituted, unless it is clear that the legal or administrative action cannot be considered material in the context of any Finance Document.

  • Procedures for Voting and Consents The rules and procedures for calling and conducting any meeting of the holders of Designated Preferred Stock (including, without limitation, the fixing of a record date in connection therewith), the solicitation and use of proxies at such a meeting, the obtaining of written consents and any other aspect or matter with regard to such a meeting or such consents shall be governed by any rules of the Board of Directors or any duly authorized committee of the Board of Directors, in its discretion, may adopt from time to time, which rules and procedures shall conform to the requirements of the Charter, the Bylaws, and applicable law and the rules of any national securities exchange or other trading facility on which Designated Preferred Stock is listed or traded at the time.

  • Antitrust Notification If the Holder determines, in its sole judgment upon the advice of counsel, that the issuance of any Warrant Shares pursuant to the terms hereof would be subject to the provisions of the Hxxx-Xxxxx-Xxxxxx Antitrust Improvements Act of 1976, as amended (the “HSR Act”), the Company shall file as soon as practicable after the date on which the Company receives notice from the Holder of the applicability of the HSR Act and a request to so file with the United States Federal Trade Commission and the United States Department of Justice the notification and report form required to be filed by it pursuant to the HSR Act in connection with such issuance.

  • Procedures for Notification and Defense of Claim (a) Indemnitee shall notify the Company in writing of any matter with respect to which Indemnitee intends to seek indemnification or advancement of Expenses as soon as reasonably practicable following the receipt by Indemnitee of notice thereof. The written notification to the Company shall include, in reasonable detail, a description of the nature of the Proceeding and the facts underlying the Proceeding. The failure by Indemnitee to notify the Company will not relieve the Company from any liability which it may have to Indemnitee hereunder or otherwise than under this Agreement, and any delay in so notifying the Company shall not constitute a waiver by Indemnitee of any rights, except to the extent that such failure or delay materially prejudices the Company.

  • Resolution of Notice of Claim Each Notice of Claim given by an Indemnitee shall be resolved as follows:

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