UTILIZATION MONITORING Clause Samples

The Utilization Monitoring clause establishes a process for tracking and reviewing the use of specific resources, services, or products under an agreement. Typically, this involves regular reporting by one party on the frequency, volume, or manner in which the contracted items are used, and may include audits or data sharing to verify compliance. Its core practical function is to ensure transparency and accountability, helping both parties confirm that resources are being used as intended and to identify any misuse or inefficiencies early on.
UTILIZATION MONITORING. The LME/PIHP shall monitor and review service utilization data related to the CONTRACTOR and the LME/PIHP’s Provider Network to ensure that services are being provided in a manner consistent with Controlling Authority and the LME/PIHP’s agreements with the Department.
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UTILIZATION MONITORING. Alliance shall monitor and review service utilization data related to the Provider and the Alliance Provider Network to ensure that services are being provided in a manner consistent with Controlling Authority.
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UTILIZATION MONITORING. The state will summarize utilization through a review of claims/encounter data for the demonstration population in the subsequent tables. This includes the following: Table 1. Utilization Monitoring Measures Table 2: Unduplicated Number of Enrollees by Quarter Number of Female Enrollees by Quarter Table 3: Unduplicated Number of Beneficiaries with any Claim by Age Group per Quarter in the Demonstration Year (to date) Number of Females Who Utilize Services by Age and Quarter Table 5: Number Beneficiaries Tested for any STD by Demonstration Year Test Total Tests Table 6: Total Number of Female Beneficiaries who obtained a Cervical Cancer Screening Table 7: Breast Cancer Screening
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UTILIZATION MONITORING. The state will summarize utilization through a review of claims/encounter data for the demonstration population in the subsequent tables. This includes the following: Table 1. Utilization Monitoring Measures Table 2: Unduplicated Number of Enrollees by Quarter Number of Female Enrollees by Quarter Table 3: Unduplicated Number of Beneficiaries with any Claim by Age Group and Gender per Quarter in the Demonstration Year Number of Females Who Utilize Services by Age and Quarter Table 5: Number Beneficiaries Tested for any STD by Demonstration Year Test Female Tests Male Tests Total Tests Table 6: Total Number of Female Beneficiaries who obtained a Cervical Cancer Screening Table 7: Breast Cancer Screening 1. General Outreach and Awareness a. Provide information on the public outreach and education activities conducted this demonstration year; and, b. Provide a brief assessment on the effectiveness of these outreach and education activities. 2. Target Outreach Campaign(s) (if applicable) a. Provide a narrative on the populations targeted for outreach and education campaigns and reasons for targeting; and, b. Provide a brief assessment on the effectiveness of these targeted outreach and education activities.
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UTILIZATION MONITORING. The BH I/DD Tailored Plan shall monitor and review service utilization data related to the Contractor and the BH I/DD Tailored Plan’s Provider Network to ensure that services are being provided in a manner consistent with Controlling Authority and the BH I/DD Tailored Plan’s Contracts with the Department.
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UTILIZATION MONITORING. CARDINAL INNOVATIONS shall monitor and review service utilization data related to the CONTRACTOR and CARDINAL INNOVATIONS’ Provider Network to insure that services are being provided in a manner consistent with CARDINAL INNOVATIONS’ agreement with the Division of Mental Health, Developmental Disabilities and Substance Abuse Services and the Division of Medical Assistance.
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UTILIZATION MONITORING. The LME shall monitor and review service utilization data related to the Contractor and the LME’s Provider Network to insure that services are being provided in a manner consistent with the LME’s agreement with the Division of Mental Health, Developmental Disabilities and Substance Abuse Services and the Division of Medical Assistance.
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Related to UTILIZATION MONITORING

  • Utilization Management Contractor shall maintain a utilization management program that complies with applicable laws, rules and regulations, including Health and Safety Code § 1367.01 and other requirements established by the applicable State Regulators responsible for oversight of Contractor.

  • Utilization Utilization shall be defined as Trunks Required as a percentage of Trunks In Service. 1 During implementation the Parties will mutually agree on an Economic Centum Call Seconds (ECCS) or some other means for the sizing of this trunk group. 4.6.3.1 In A Blocking Situation (Over-utilization): 4.6.3.1.1 In a blocking situation, CLEC is responsible for issuing ASRs on all two-way Local Only, Local Interconnection, Third Party and Meet Point Trunk Groups and one-way CLEC originating Local Only and/or Local Interconnection Trunk Groups to reduce measured blocking to design objective blocking levels based on analysis of trunk group data. If an ASR is not issued, AT&T-21STATE will issue a TGSR. CLEC will issue an ASR within three (3) business days after receipt and review of the TGSR. CLEC will note “Service Affecting” on the ASR. 4.6.3.1.2 In a blocking situation, AT&T-21STATE is responsible for issuing ASRs on one-way AT&T-21STATE originating Local Only and/or Local Interconnection Trunk Groups to reduce measured blocking to design objective blocking levels based on analysis of trunk group data. If an ASR is not issued, CLEC will issue a TGSR. AT&T- 21STATE will issue an ASR within three (3) business days after receipt and review of the TGSR. 4.6.3.1.3 If an alternate final Local Only Trunk Group or Local Interconnection Trunk Group is at seventy-five percent (75%) utilization, a TGSR may be sent to CLEC for the final trunk group and all subtending high usage trunk groups that are contributing any amount of overflow to the alternate final route. 4.6.3.1.4 If a direct final Meet Point Trunk Group is at seventy-five percent (75%) utilization, a TGSR may be sent to CLEC. If a direct final Third Party Trunk Group is at ninety percent (90%) utilization, a TGSR may be sent to CLEC.

  • Program Monitoring The Contractor will make all records and documents required under this Agreement as outlined here, in OEC Policies and NHECC Policies available to the SRO or its designee, the SR Fiscal Officer or their designee and the OEC. Scheduled monitoring visits will take place twice a year. The SRO and OEC reserve the right to make unannounced visits.

  • Project Monitoring The Developer shall provide regular status reports to the NYISO in accordance with the monitoring requirements set forth in the Development Schedule, the Public Policy Transmission Planning Process Manual and Attachment Y of the OATT.

  • Contract Monitoring The criminal background checks required by this rule shall be national in scope, and must be conducted at least once every three (3) years. Contractor shall make the criminal background checks required by Paragraph IV.G.1 available for inspection and copying by DRS personnel upon request of DRS.