Services Not Dentally Necessary Sample Clauses

Services Not Dentally Necessary. This agreement does NOT cover services to identify or treat your dental or oral health conditions that are NOT dentally necessary in accordance with our dental policies and related guidelines (See Section 8.0 – Glossary). We will use any reasonable means to make a determination about the dental necessity of your care. We may examine dental records. We review dental necessity in accordance with our dental policies and related guidelines. You have the right to appeal our determination or to take legal action as described in Section 7.0. We may deny payments if a dentist does not supply dental records needed to determine dental necessity. We also may deny or reduce payment if the records sent to us do not provide adequate justification for performing the service. This agreement does NOT cover orthodontic services that are NOT medically necessary in accordance with our dental policies and related guidelines (See Section 8.0 – Glossary).
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Related to Services Not Dentally Necessary

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  • Information and Services Required of the Owner § 3.1.1 The Owner shall provide information with reasonable promptness, regarding requirements for and limitations on the Project, including a written program which shall set forth the Owner’s objectives, constraints, and criteria, including schedule, space requirements and relationships, flexibility and expandability, special equipment, systems, sustainability and site requirements.

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  • Specialized Services The specialized consultant services identified in the following list are included in Additional Services: Providing financial feasibility or other special studies. Providing planning surveys, site evaluations, environmental studies or comparative studies of prospective sites. Providing services relative to future facilities, systems and equipment which are not intended to be constructed during the Construction Phase. Providing services to make detailed investigation of existing conditions or facilities or to make measured drawings thereof, other than to verify the accuracy of drawings or other information furnished by the Owner. Providing coordination of Work performed by Owner’s separate Contractors or by the Owner’s own forces. Providing services in connection with the Work of a Contractor or separate consultants retained by the Owner other than commissioning consultant, testing and balance consultant, material testing firms or similar firms. Providing services for planning tenant or rental spaces. Making revisions in Drawings, Specifications or other documents when such revisions are inconsistent with written approvals or instructions previously given are required by the enactment or revision of codes, laws of regulations subsequent to the preparation of such documents or are due to other causes not solely within the control of the Project Architect. Making extensive investigations, surveys, valuations, inventories or detailed appraisals of existing facilities, except as otherwise required by the Agreement, and ser­vices required in connec­tion with construction performed by the Owner. Providing consultation concerning replacement of any Work damaged by fire or other cause during construction, and furnishing services as may be required in connection with the replacement of such Work. Providing services made necessary by the default of the Contractor, or by major defects or deficiencies in the Work of the Contractor, or by failure of performance of the Contractor under the Contract for Construction. Providing extensive assistance in the utilization of any equipment or system such as initial start-up or testing, adjusting and balancing, preparation of operation and maintenance manuals, training personnel for operation and maintenance, and consultation during operation. Providing services after the expiration of sixty (60) days following final payment to the Contractor, excluding any services necessary during the warranty period inspections and provided that all of Project Architect’s services as required under this Agreement have been satisfactorily completed. Preparing to serve or serving as an expert witness at the request of the Owner in connection with any public hearing, arbitration proceeding or legal proceeding. Providing any other services not otherwise customarily furnished in accordance with generally accepted architectural practice.

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