Third Party Payor Programs in General Sample Clauses

Third Party Payor Programs in General. We participate in the Medicaid and EAEDC Programs as a provider of Residential facility care and services. If you are eligible for benefits under either program, we agree to accept payment from the Program in lieu of our daily rate; however, you remain responsible for paying all co-payments, co-insurance, deductibles, patient paid amounts and charges for items and services that the Program does not cover. We also participate as providers of residential facility care and services offered by other third party payors such as private insurance companies. If you are entitled to benefits under insurance offered by a non-Medicaid insurance program and if we participate as a provider under the program, we agree to accept payment from the program in lieu of our daily rate; however, you remain responsible for paying all co-payments, coinsurance, deductibles, patient paid amounts and charges for items and services that the program does not cover. Information concerning coverage under the Medicaid and EAEDC programs, as applicable, is set forth in Appendix B to this Agreement.
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Third Party Payor Programs in General. We participate in the Medicare Program as a provider of nursing facility care and services. If you are eligible for Medicare benefits, we agree to accept payment from the Program in lieu of our daily rate; however, you remain responsible for paying all co-payments, coinsurance, deductibles, patient paid amounts and charges for items and services that the Program does not cover. We also participate as providers of nursing facility care and services offered by other third party payors such as private insurance companies. If you are entitled to benefits under insurance offered by a non-Medicare insurance program and if we participate as a provider under the program, we agree to accept payment from the program in lieu of our daily rate; however, you remain responsible for paying all co-payments, coinsurance, deductibles, patient paid amounts and charges for items and services that the program does not cover. Any appeal of a private insurance coverage decision is solely your responsibility and a pending appeal will not impact your obligation to pay for the services for which coverage was denied. If insurance payment is ultimately received, we will promptly reimburse you. Information concerning coverage under the Medicare program, is set forth in Exhibit B to this Agreement. We do not participate in the Medicaid/MassHealth program.
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Related to Third Party Payor Programs in General

  • THIRD PARTY PROGRAMS This Licensed Software may contain third party software programs (“Third Party Programs”) that are available under open source or free software licenses. This License Agreement does not alter any rights or obligations You may have under those open source or free software licenses. Notwithstanding anything to the contrary contained in such licenses, the disclaimer of warranties and the limitation of liability provisions in this License Agreement shall apply to such Third Party Programs.

  • Third Party Providers Except for those terms and conditions that specifically apply to Third Party Providers, under no circumstances shall any other person be considered a third party beneficiary of this Agreement or otherwise entitled to any rights or remedies under this Agreement. Except as may be provided in Third Party Agreements, Company shall have no rights or remedies against Third Party Providers, Third Party Providers shall have no liability of any nature to the Company, and the aggregate cumulative liability of all Third Party Providers to the Company shall be $1.

  • Third Party Payments Neither the Advisor nor any of its officers, directors, employees or stockholders shall receive any commissions, compensation, remuneration or payments whatsoever from any broker with which the Company carries an account for transactions executed in the Company’s account. The parties acknowledge that a familial relationship of any of the foregoing persons may receive floor brokerage commissions in respect of trades effected pursuant to the Advisor’s Trading Approach on behalf of the Company, which payment shall not violate the preceding sentence.

  • Third Party Products 1. Third Party Hardware. We will sell, deliver, and install onsite the Third Party Hardware, if you have purchased any, for the price set forth in the Investment Summary. Those amounts are payable in accordance with our Invoicing and Payment Policy.

  • Mentor Program a. Each new Bargaining Unit Member (first year employee) shall be assigned a mentor. An exception may be made, as determined by the Superintendent, for new part-time Bargaining unit Members of whom have prior service in the same program operated by the Board. The mentor shall assist the new Bargaining Unit Member in general teaching procedures, techniques, classroom planning and organization, school functions and regulations and other areas of professional growth and development. The Association President in collaboration with the Lead Mentor/Resident Educator Coordinator and appropriate Directors shall submit nominations of three (3) qualified staff members to the Superintendent, after obtaining the candidates’ permission. The Superintendent may elect to nominate one of the candidates to the Board of Education for assignment, or ask the Association President and Lead Mentor/Resident Educator Coordinator for additional nominations.

  • Third Party Users If required by Applicable Laws and Regulations or if the Parties mutually agree, such agreement not to be unreasonably withheld, to allow one or more third parties to use the Connecting Transmission Owner’s Attachment Facilities, or any part thereof, Developer will be entitled to compensation for the capital expenses it incurred in connection with the Attachment Facilities based upon the pro rata use of the Attachment Facilities by Connecting Transmission Owner, all third party users, and Developer, in accordance with Applicable Laws and Regulations or upon some other mutually-agreed upon methodology. In addition, cost responsibility for ongoing costs, including operation and maintenance costs associated with the Attachment Facilities, will be allocated between Developer and any third party users based upon the pro rata use of the Attachment Facilities by Connecting Transmission Owner, all third party users, and Developer, in accordance with Applicable Laws and Regulations or upon some other mutually agreed upon methodology. If the issue of such compensation or allocation cannot be resolved through such negotiations, it shall be submitted to FERC for resolution.

  • Medicaid If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements and is not entitled to any other third party coverage, the Resident may be eligible for Medicaid (often referred to as the “payor of last resort”). THE RESIDENT, RESIDENT REPRESENTATIVE AND SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS (APPROXIMATELY $50,000) AND/OR INSURANCE COVERAGE TO CONFIRM THAT A MEDICAID APPLICATION HAS OR WILL BE SUBMITTED TIMELY AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, RESIDENT REPRESENTATIVE AND/OR SPONSOR AGREE TO PREPARE AND FILE AN APPLICATION FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. Once a Medicaid application has been submitted on the Resident’s behalf, the Resident, Sponsor, and Resident Representative agree to pay, to the extent they have access to the Resident’s funds, to the Facility the Resident’s monthly income, which will be owed to the Facility under the Resident’s Medicaid budget. Medicaid recipients are required to pay their Net Available Monthly Income (“NAMI”) to the Facility on a monthly basis as a co-payment obligation as part of the Medicaid rate. A Resident’s NAMI equals his or her income (e.g., Social Security, pension, etc.), less allowed deductions. The Facility has no control over the determination of NAMI amounts, and it is the obligation of the Resident, Resident Representative and/or Sponsor to appeal any disputed NAMI calculation with the appropriate government agency. Once Medicaid eligibility is established, the Resident, Resident Representative and/or Sponsor agree to pay NAMI to the Facility or to arrange to have the income redirected by direct deposit to the Facility and to ensure timely Medicaid recertification. The Resident, Sponsor and Resident Representative agree to provide to the Facility copies of any notices (such as requests for information, budget letters, recertification, denials, etc.) they receive from the Department of Social Services related to the Resident’s Medicaid coverage. Until Medicaid is approved, the Facility may bill the Resident’s account as private pay and the Resident will be responsible for the Facility’s private pay rate. If Medicaid denies coverage, the Resident or the Resident’s authorized representative can appeal such denial; however, payment for any uncovered services will be owed to the Facility at the private pay rate pending the appeal determination. If Medicaid eligibility is established and retroactively covers any period for which private payment has been made, the Facility agrees to refund or credit any amount in excess of the NAMI owed during the covered period.

  • Third Party Service Providers Unless otherwise prohibited by Apple in the Documentation or this Agreement, You are permitted to employ or retain a third party (“Service Provider”) to assist You in using the Apple Software and Services provided pursuant to this Agreement, including, but not limited to, engaging any such Service Provider to maintain and administer Your Applications’ servers on Your behalf, provided that any such Service Provider’s use of the Apple Software and Services or any materials associated therewith is done solely on Your behalf and only in accordance with these terms. Notwithstanding the foregoing, You may not use a Service Provider to submit an Application to the App Store or use TestFlight on Your behalf. You agree to have a binding written agreement with Your Service Provider with terms at least as restrictive and protective of Apple as those set forth herein. Any actions undertaken by any such Service Provider in relation to Your Applications or use of the Apple Software or Apple Services and/or arising out of this Agreement shall be deemed to have been taken by You, and You (in addition to the Service Provider) shall be responsible to Apple for all such actions (or any inactions). In the event of any actions or inactions by the Service Provider that would constitute a violation of this Agreement or otherwise cause any harm, Apple reserves the right to require You to cease using such Service Provider.

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