Resolution of Requests for Prior Authorization Sample Clauses

Resolution of Requests for Prior Authorization. 2.9.11.4.1 The CONTRACTOR agrees, and recognizes that the DBM has agreed through its contractual arrangement with the State, that any dispute concerning which party should respond to a request for prior authorization shall not cause a denial, delay, reduction, termination or suspension of any appropriate service to a TennCare enrollee. The CONTRACTOR shall require that its DBM care coordinators will, in addition to their responsibilities for DBM care coordination, deal with issues related to requests for prior authorization that require coordination between the DBM and the CONTRACTOR. The CONTRACTOR shall provide the DBM with a list of its DBM care coordinators and telephone number(s) at which each DBM care coordinator may be contacted. When the CONTRACTOR receives a request for prior authorization from a provider for a member and the CONTRACTOR believes the service is the responsibility of the DBM, the CONTRACTOR’s DBM care coordinator shall contact the DBM’s care coordinator by the next business day after receiving the request for prior authorization. The DBM care coordinator shall also contact the member and/or member’s provider. For routine requests contact to the member or member’s provider shall be made within fourteen (14) days or less of the provider’s request for prior authorization and shall comply with all applicable consent decrees and court orders and TennCare rules and regulations. For urgent requests, contact shall be made immediately after receiving the request for prior authorization. 2.9.11.4.2 The CONTRACTOR shall assign staff members to serve on a coordination committee with DBM staff members. This committee shall be responsible for addressing all issues of dental care coordination. The committee will review disputes regarding clinical care and provide a clinical resolution to the dispute, subject to the terms of this Agreement. The CONTRACTOR and the DBM shall attempt in good faith to resolve any dispute and communicate the decision to the provider requesting prior authorization of a service. In the event the CONTRACTOR and the DBM cannot agree within ten (10) calendar days of the provider’s request for prior authorization, the party who first received the request from the provider shall be responsible for prior authorization and payment to the contract provider within the time frames designated by TENNCARE. The CONTRACTOR and the DBM are responsible for enforcing hold harmless protection for the member. The CONTRACTOR shall ensure tha...
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Related to Resolution of Requests for Prior Authorization

  • Requests for Approval If the Administrative Agent requests in writing the consent or approval of a Lender, such Lender shall respond and either approve or disapprove definitively in writing to the Administrative Agent within ten Business Days (or sooner if such notice specifies a shorter period for responses based on Administrative Agent’s good faith determination that circumstances exist warranting its request for an earlier response) after such written request from the Administrative Agent. If the Lender does not so respond, that Lender shall be deemed to have approved the request.

  • Procedures for LNP Request The Parties shall provide for the requesting of End Office LNP capability on a reciprocal basis through a written request. The Parties acknowledge that Verizon has deployed LNP throughout its network in compliance with FCC 96-286 and other applicable FCC Regulations. 15.4.1 If Party B desires to have LNP capability deployed in an End Office of Party A, which is not currently capable, Party B shall issue a LNP request to Party A. Party A will respond to the Party B, within ten (10) days of receipt of the request, with a date for which LNP will be available in the requested End Office. Party A shall proceed to provide for LNP in compliance with the procedures and timelines set forth in FCC 00-000, Xxxxxxxxx 80, and FCC 97-74, Paragraphs 65 through 67. 15.4.2 The Parties acknowledge that each can determine the LNP-capable End Offices of the other through the Local Exchange Routing Guide (LERG). In addition, the Parties shall make information available upon request showing their respective LNP-capable End Offices, as set forth in this Section 15.4.

  • NOTIFICATIONS AND SUBMISSION OF REPORTS Unless otherwise stated in writing after the Effective Date, all notifications and reports required under this IA shall be submitted to the following entities: Administrative and Civil Remedies Branch Office of Counsel to the Inspector General Office of Inspector General U.S. Department of Health and Human Services Xxxxx Building, Room 5527 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxxxxxxxx, XX 00000 Telephone: (000) 000-0000 Facsimile: (000) 000-0000 LFAC: Xxxxxxx X. Xxxxx, DPM 0000 Xxxxxxxxxxx Xx. X-000 Xxxxxxxxx, XX 00000 Telephone: (000) 000-0000 Email: xx.xxxxx@xxxxx.xxx Unless otherwise specified, all notifications and reports required by this IA may be made by electronic mail, overnight mail, hand delivery, or other means, provided that there is proof that such notification was received. Upon request by OIG, LFAC may be required to provide OIG with an additional copy of each notification or report required by this IA in OIG’s requested format (electronic or paper).

  • Execution of requests 1. In order to comply with a request for assistance, the requested authority shall proceed, within the limits of its competence and available resources, as though it were acting on its own account or upon request of other authorities of that same Party, by supplying information already possessed, by carrying out appropriate inquiries, or by arranging for them to be carried out. This paragraph shall also apply to any other authority to which the request has been addressed by the requested authority when the latter cannot act on its own. 2. Requests for assistance shall be executed in accordance with the legal or regulatory provisions of the requested Party and the answer shall be sent at the latest within 120 days following the date of the receipt of the request. 3. Duly authorized officials of a Party may be present in the offices of the requested authority or any other concerned authority in accordance with paragraph 1, to obtain information related to activities that are or may be operations in breach of customs legislation which the applicant authority needs for purposes of this Chapter. 4. Duly authorized officials of a Party involved may be present at inquiries or verifications carried out in the territory of the other Party.

  • Application for approval 3.1. The application for approval of a vehicle type with regard to the AEBS shall be submitted by the vehicle manufacturer or by his authorised representative. 3.2. It shall be accompanied by the documents mentioned below in triplicate: 3.2.1. A description of the vehicle type with regard to the items mentioned in paragraph 2.4., together with a documentation package which gives access to the basic design of the AEBS and the means by which it is linked to other vehicle systems or by which it directly controls output variables. The numbers and/or symbols identifying the vehicle type shall be specified. 3.3. A vehicle representative of the vehicle type to be approved shall be submitted to the Technical Service conducting the approval tests.

  • Attachment C, Standard State Provisions for Contracts and Grants Attachment C is hereby deleted in its entirety and replaced by the Attachment C December 15, 2017 attached to this Amendment. Child Support (Applicable to natural persons only; not applicable to corporations, partnerships or LLCs). Contractor is under no obligation to pay child support or is in good standing with respect to or in full compliance with a plan to pay any and all child support payable under a support order as of the date of this amendment.

  • Deadline for Submission of Bids 19.1 Bids must be received by the Purchaser at the address specified under ITB Clause 18.2 no later than the time and date specified in the Bid Data Sheet.

  • REQUESTS FOR FLEXIBLE WORKING ARRANGEMENTS 49.1 Employee may request change in working arrangements s.65 of the Act. Note 1: Section 65 of the Act provides for certain Employees to request a change in their working arrangements because of their circumstances, as set out in s.65(1A).

  • SUBMISSION OF REPORTS All applicable study reports shall be submitted in preliminary form for approval by the State before a final report is issued. The State's comments on the Engineer's preliminary report must be addressed in the final report.

  • Submission of Bids The Tender shall be submitted in two part: one comprising a Technical Tender and one containing the Commercial Tender. The Technical Tender shall contain all the required documents requested in the Tender Documents excluding any financial references. The Commercial Tender shall contain all financial documents and information. Bidders who fail to adhere to this requirement will result in the disqualification of their Tender. The Bid Form together with all information and documentation shall be completed and submitted by email only. The bidder must affix its initialed company stamp to every page of its original Tender submission which should include all parts of the Tender Documents. The original shall be clearly marked “ORIGINAL” Bidders not complying with the requirements of the Bid Form and the submission and delivery of the bids may be deemed non-responsive to the Invitation to Tender and their bids may be excluded from further consideration. The Bidders should submit the bids which should be signed by Authorized person of the company and company may verify if it is required from CEO or Owner of bidder or any other Agencies e.g. Chamber of Commerce. . No deletions or erasures may be made in the list of prices and the schedule of categories. Any correction in the prices etc. shall be re-written in numbers and words and signed by the authorized person. The bidder may not delete or modify any clauses or technical specifications irrespective of the nature of such modification. Any special conditions or modifications shall be sent in or attached with a separate letter kept in the tender envelope. A reference shall be made to this letter in the bid itself. No other alternative shall be acceptable. The price schedule shall specify whether the item is manufactured in the Sultanate of Oman or abroad. Inaccuracy of the information submitted, partly or fully, shall lead to the rejection of the item without prejudice to the Abraj Tender Committee’s right to deprive the bidder of the facility to deal with other tenders of the Company within a period specified by the relevant Abraj Tender Committee (ATC), depending on the situation of each case. The prices quoted by the bidder in the schedule of categories shall include and cover all the expenses and liabilities, irrespective of their nature, to be incurred or met in respect of each clause and shall also include those involved in the completion, delivery and maintenance if required, of all the works during the period of guarantee and maintenance. The final calculation shall be done on the basis of these prices irrespective of fluctuations in the market, the customs duty and other duties and taxes. The bidder shall, in case of the submission of one or more alternative offer, ensure that these offers are clear and detailed and referred to in the list of contents. If the bidder fails to specify the price of an item required to be supplied in the price list, this shall be considered as abstention from participation in the tender in respect of such item. The prices specified in words shall be accepted. As an exception, the relevant may accept the offer specified in numbers only in the Company’s interest. A bid based on a reduction in the lowest bid by a specified percentage shall also not be acceptable. To submit the Commercial bid, the following shall be taken into account: a. If the goods are required to be delivered on board the ship, the price given in the bid shall include the price of the items, adding thereto the expenses for mobilization, transportation and loading in accordance with the FOB system. b. If the goods are required to be delivered at the port of arrival, the price given in the bid shall include the price of the items, adding thereto the expenses for mobilization, transportation, loading and shipping in accordance with the C & F system. c. If the goods are required to be delivered at the port of arrival, the price given in the bid shall include the price of the items, adding thereto the expenses for mobilization, transportation, loading, shipping, insurance and unloading in accordance with the CIF system. d. If the goods are required to be delivered at the stores of the purchaser or the work sites, the price given in the bid shall include the price of the items, adding thereto the expenses for mobilization, transportation and loading, the shipment charges, the insurance cost and expenses on unloading, customs duties, internal transportation and other additional charges. e. In all cases, the contractor shall bear all the expenses for getting the letter of credit from the Company pertaining to their banker while the Company shall bear the letter of credit opening charges pertaining to its banker in Oman. f. The data or information for Commercial Bid submission will be as per attached Annexure-10. Bidders accept full responsibility for ensuring their bids are delivered or submitted to the correct email address by the specified deadline. Bids submitted to any other address or later than the deadline may not be considered. Bidders forwarding their bids by courier should advise by email to Xxxxxxxx@xxxxxxxxxxx.xxx , when the bid has been sent by courier, naming the courier and tracing number. Bids received after the final bid submission deadline will be returned unopened to the bidder. Company expressly reserves the right to extend the bid submission deadline. You have to forward your offer in soft copy addressed to the Senior Tender Committee to the mail ID: Xxxxxx.XXX@xxxxxxxxxxx.xxx on or before official Bid closing date.

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