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Transparency and Quality Reporting Sample Clauses

Transparency and Quality Reporting a) Pursuant to 45 C.F.R. § 156.220 and Centers for Medicare & Medicaid Services Transparency in Coverage requirements, Contractor shall provide Covered California and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to Covered California and Enrollees, the data as required by Covered California. This includes information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, appeals, rating practices, cost-sharing, payments with respect to any out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to Covered California and Enrollees in plain language. b) Contractor shall timely respond to a Covered California Enrollee’s request for cost sharing information and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.
Transparency and Quality Reporting. (a) Pursuant to 45 C.F.R. § 156.220 and Centers for Medicare & Medicaid Services Transparency in Coverage requirements, Contractor shall provide Covered California and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to Covered California and Enrollees the data as required by Covered California. This includes disclosing applicable information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, appeals, rating practices, cost-sharing, payments with regard to any out-of-network coverage, and Enrollee rights. Contractor may include pre- treatment estimates as one method of satisfying this obligation. Contractor shall provide information required under this section to Covered California and Enrollees in plain language.
Transparency and Quality Reporting. (a) Pursuant to 45 C.F.R. § 156.220 and Centers for Medicare & Medicaid Services Transparency in Coverage requirements, Contractor shall provide Covered California and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to Covered California and Enrollees the data as required by Covered California. This includes disclosing applicable information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, appeals, rating practices, cost- sharing, payments with regard to any out-of-network coverage, and Enrollee rights. Contractor may include pre-treatment estimates as one method of satisfying this obligation. Contractor shall provide information required under this section to Covered California and Enrollees in plain language. (b) Contractor shall timely respond to an Enrollee’s request for cost sharing information and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.
Transparency and Quality Reporting a) Pursuant to 45 C.F.R. § 156.220, Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to the Exchange and Enrollees, the data as required by the Exchange. This includes information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with respect to any out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language. b) Contractor shall timely respond to an Enrollee’s request for cost sharing information and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.
Transparency and Quality Reporting. (a) Pursuant to 45 C.F.R. § 156.220, Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to the Exchange and Enrollees the data as required by the Exchange. This includes disclosing applicable information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with regard to any out-of-network coverage, and Enrollee rights. Contractor may include pre- treatment estimates as one method of satisfying this obligation. Contractor shall provide information required under this section to the Exchange and Enrollees in plain language. (b) Contractor shall timely respond to an Enrollee’s request for cost sharing information, and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.
Transparency and Quality Reporting a) Pursuant to 45 CFR § 156.220, Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to the Exchange and Enrollees the data required no later than March 31st of each year. This includes information relating to claims payment policies and practices, financial disclosures, enrollment, disenrollment, denials, rating practices, cost-sharing, out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language. b) Contractor shall timely respond to an Enrollee’s request for cost sharing information and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.
Transparency and Quality Reporting. ‌ a) Pursuant to 45 C.F.R. § 156.220, Contractor shall provide the Exchange and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to the Exchange and Enrollees the data as required by the Exchange. This includes information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, rating practices, cost-sharing, payments with respect to any out-of-network coverage, and Enrollee rights. Contractor shall provide information required under this Section to the Exchange and Enrollees in plain language.
Transparency and Quality Reporting. (a) Pursuant to 45 C.F.R. § 156.220 and Centers for Medicare & Medicaid Services Transparency in Coverage requirements, Contractor shall provide Covered California and Enrollees with information reasonably necessary to provide transparency in Contractor’s coverage, and report to Covered California and Enrollees the data as required by Covered California. This includes disclosing applicable information relating to claims payment policies and practices, periodic financial disclosures, enrollment, disenrollment, claims denials, appeals, rating practices, cost-sharing, payments with regard to any out-of-network coverage, and Enrollee rights. Contractor may include pre-treatment estimates as one method of satisfying this obligation. Contractor shall provide information required under this section to Covered California and Enrollees in plain language. (b) Contractor shall timely respond to a Covered California Enrollee’s request for cost sharing information and shall make cost sharing information available to individuals through the internet and pursuant to other means for individuals without internet access in a timely manner.

Related to Transparency and Quality Reporting

  • Reporting and Record Keeping CONTRACTOR shall comply with all program and fiscal reporting requirements set forth by appropriate Federal, State and local agencies, and as required by the COUNTY. (c) CONTRACTOR agrees to provide to COUNTY, to any Federal or State department having monitoring or review authority, to COUNTY's authorized representatives, and/or their appropriate audit agencies upon reasonable notice, access to and the right to examine all records and documents necessary to determine compliance with relevant Federal, State, and local statutes, rules and regulations, and this Agreement, and to evaluate the quality, appropriateness and timeliness of services performed.