Your Agreement to Seek Benefits From and Cooperate with Third Party Payors Sample Clauses

Your Agreement to Seek Benefits From and Cooperate with Third Party Payors. If you are eligible for any third party payor benefit (whether under the Medicare Program, Medicaid Program or other insurance plan), you agree to apply for any such benefit in a timely manner and to cooperate in complying with all requirements of such third party payor, including submitting any and all information necessary to process your application for coverage. We agree to assist you through our Social Service Department in applying for benefits from a third party payor. To facilitate our ability to assist you, we request that you notify us two (2) months prior to the time you anticipate being eligible for any benefits. We agree to apply any and all money we receive from you toward the cost of your maintenance before you make any application for assistance to any third party payor. You agree, if applying for Medicaid benefits, to comply with Medicaid requirements in order to become eligible. These requirements may include providing correct and complete information about previous transfers of assets and other matters and may require liquidation of certain assets. If determined eligible for Medicaid, you agree to pay any patient pay amount determined by Medicaid, subject to any rights you have to appeal the patient pay amount determination. We agree not to discriminate against you because you have applied for or obtained any third party payor nursing facility care and services benefit. If you apply for Medicaid benefits and your application is approved, you may be required to contribute to the cost of the care and services we provide to you from such sources as social security benefits and pension benefits. In such circumstances, you agree to pay to us from your benefits the amount determined to be your contribution toward the cost of the care and services we provide to you. If you apply for Medicaid benefits and your application is denied, you agree that we may, if we so choose, appeal your denial of Medicaid benefits as your authorized representative. In the event you fail to pay for your care, we will notify you and a person you designate. If you do not pay for your care or commence application for Medicaid benefits in a timely manner after our notification, we may apply for such benefits on your behalf as your representative. We reserve the right to terminate our participation in any third-party payor program, including, but not limited to, the Medicaid and Medicare Programs. In the event of such termination, we agree to provide discharge planning t...
Sample 1
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Your Agreement to Seek Benefits From and Cooperate with Third Party Payors. If you are eligible for any third party payor benefit (whether under the Medicare Program or other insurance plan), you agree to apply for any such benefit in a timely manner and to cooperate in complying with all requirements of such third party payor, including submitting any and all information necessary to process your application for coverage. In the event you fail to pay for your care, we will notify you and a person you designate.
Sample 1

Related to Your Agreement to Seek Benefits From and Cooperate with Third Party Payors

  • CERTIFICATION PROHIBITING DISCRIMINATION AGAINST FIREARM AND AMMUNITION INDUSTRIES (Texas law as of September 1, 2021) By submitting a proposal to this Solicitation, you certify that you agree, when it is applicable, to the following required by Texas law as of September 1, 2021: If (a) company is not a sole proprietorship; (b) company has at least ten (10) full-time employees; (c) this contract has a value of at least $100,000 that is paid wholly or partly from public funds; (d) the contract is not excepted under Tex. Gov’t Code § 2274.003 of SB 19 (87th leg.); and (e) governmental entity has determined that company is not a sole-source provider or governmental entity has not received any bids from a company that is able to provide this written verification, the following certification shall apply; otherwise, this certification is not required. Pursuant to Tex. Gov’t Code Ch. 2274 of SB 19 (87th session), the company hereby certifies and verifies that the company, or association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majority-owned subsidiary parent company, or affiliate of these entities or associations, that exists to make a profit, does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association and will not discriminate during the term of this contract against a firearm entity or firearm trade association. For purposes of this contract, “discriminate against a firearm entity or firearm trade association” shall mean, with respect to the entity or association, to: “(1) refuse to engage in the trade of any goods or services with the entity or association based solely on its status as a firearm entity or firearm trade association; (2) refrain from continuing an existing business relationship with the entity or association based solely on its status as a firearm entity or firearm trade association; or (3) terminate an existing business relationship with the entity or association based solely on its status as a firearm entity or firearm trade association. See Tex. Gov’t Code § 2274.001(3) of SB 19. “Discrimination against a firearm entity or firearm trade association” does not include: “(1) the established policies of a merchant, retail seller, or platform that restrict or prohibit the listing or selling of ammunition, firearms, or firearm accessories; and (2) a company’s refusal to engage in the trade of any goods or services, decision to refrain from continuing an existing business relationship, or decision to terminate an existing business relationship to comply with federal, state, or local law, policy, or regulations or a directive by a regulatory agency, or for any traditional business reason that is specific to the customer or potential customer and not based solely on an entity’s or association’s status as a firearm entity or firearm trade association.” See Tex. Gov’t Code § 2274.001(3) of SB 19.

  • CERTIFICATION PROHIBITING DISCRIMINATION AGAINST FIREARM AND AMMUNITION INDUSTRIES (Texas law as of September 1, 2021) By submitting a proposal to this Solicitation, you certify that you agree, when it is applicable, to the following required by Texas law as of September 1, 2021: If (a) company is not a sole proprietorship; (b) company has at least ten (10) full-time employees; (c) this contract has a value of at least $100,000 that is paid wholly or partly from public funds; (d) the contract is not excepted under Tex. Gov’t Code § 2274.003 of SB 19 (87th leg.); and (e) governmental entity has determined that company is not a sole-source provider or governmental entity has not received any bids from a company that is able to provide this written verification, the following certification shall apply; otherwise, this certification is not required. Pursuant to Tex. Gov’t Code Ch. 2274 of SB 19 (87th session), the company hereby certifies and verifies that the company, or association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majority-owned subsidiary parent company, or affiliate of these entities or associations, that exists to make a profit, does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association and will not discriminate during the term of this contract against a firearm entity or firearm trade association. For purposes of this contract, “discriminate against a firearm entity or firearm trade association” shall mean, with respect to the entity or association, to: “(1) refuse to engage in the trade of any goods or services with the entity or association based solely on its status as a firearm entity or firearm trade association; (2) refrain from continuing an existing business relationship with the entity or association based solely on its status as a firearm entity or firearm trade association; or (3) terminate an existing business relationship with the entity or association based solely on its status as a firearm entity or firearm trade association. See Tex. Gov’t Code § 2274.001(3) of SB 19. “Discrimination against a firearm entity or firearm trade association” does not include: “(1) the established policies of a merchant, retail seller, or platform that restrict or prohibit the listing or selling of ammunition, firearms, or firearm accessories; and (2) a company’s refusal to engage in the trade of any goods or services, decision to refrain from continuing an existing business relationship, or decision to terminate an existing business relationship to comply with federal, state, or local law, policy, or regulations or a directive by a regulatory agency, or for any traditional business reason that is specific to the customer or potential customer and not based solely on an entity’s or association’s status as a firearm entity or firearm trade association.” See Tex. Gov’t Code § 2274.001(3) of SB 19.

  • Provide Data in Compliance with Applicable Laws LEA shall provide Student Data for the purposes of obtaining the Services in compliance with all applicable federal, state, and local privacy laws, rules, and regulations, all as may be amended from time to time.

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