Integrated Coverage Determination Notice definition

Integrated Coverage Determination Notice means the Contractor will provide Enrollee with written notice of any adverse action by use of single notice specific to the item or service type in question, approved jointly by CMS and the State. The notice will comply with all requirements of 42 CFR § 422.631(d).
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Examples of Integrated Coverage Determination Notice in a sentence

  • If we decide to deny a service authorization request or to approve it for an amount that is less than asked for, you will receive a notice called an Integrated Coverage Determination Notice.

  • If you receive an Integrated Coverage Determination Notice and disagree with our decision, you have the right to make an appeal.

  • Steps to file a Level 1 Appeal:• If you are not satisfied with our decision, you have 60 days from the date on the Integrated Coverage Determination Notice to file an appeal.

  • If you want a friend, relative, or other person to be your representative during your appeal, you can complete the Appeal Request Form that was attached to the Integrated Coverage Determination Notice, complete an “Appointment of Representative” form, or write and sign a letter naming your representative.– To get an “Appointment of Representative” form, call Member Services and ask for the form.

  • Steps to file a Level 1 Appeal: • If you are not satisfied with our decision, you have 60 days from the date on the Integrated Coverage Determination Notice to file an appeal.

  • If you want a friend, relative, or other person to be your representative during your appeal, you can complete the Appeal Request Form that was attached to the Integrated Coverage Determination Notice, complete an “Appointment of Representative” form, or write and sign a letter naming your representative.- To get an “Appointment of Representative” form, call Member Services and ask for the form.

  • If you want a friend, relative, or other person to be your representative during your appeal, you can complete the Appeal Request Form that was attached to the Integrated Coverage Determination Notice, complete an “Appointment of Representative” form, or write and sign a letter naming your representative.

  • If we decide to deny a service authorization request or to approve it for an amount that is less than asked for, you will receive a notice called an Integrated Coverage Determination Notice.If you receive an Integrated Coverage Determination Notice and disagree with our decision, you have the right to make an appeal.

  • If you want a friend, relative, or other person to be your representative during your appeal, you can complete the Appeal Request Form that was attached to the Integrated Coverage Determination Notice, complete an “Appointment of Representative” form, or write and sign a letter naming your representative.– To get an “Appointment of Representative” form, call 24/7 Help Line and ask for the form.

  • Steps to file a Level 1 Appeal: If you are not satisfied with our decision, you have 60 days from the date on the Integrated Coverage Determination Notice to file an appeal.

Related to Integrated Coverage Determination Notice

  • Claim Determination Period means a calendar year. However, it does not include any part of a year during which a person has no coverage under This Plan, or any part of a year before the date this COB provision or a similar provision takes effect.

  • Determination Notice is defined in Section 6.1(b)(i) of the Agreement.

  • Event Determination Date means either:

  • Periodic Term SOFR Determination Day has the meaning specified in the definition of “Term SOFR”.

  • Extension Determination Date means, in respect of a Series of Covered Bonds, the date falling two Business Days after the expiry of seven days from (and including) the Final Maturity Date of such Covered Bonds.

  • ABR Term SOFR Determination Day has the meaning specified in the definition of “Term SOFR”.

  • Early Termination Notice is defined in Section 4.2 of this Agreement.

  • Eligibility Determination means an approval or denial of eligibility and a renewal or termination of eligibility as set forth in OAR 410-200-0015;¶

  • Share Termination Alternative If applicable, Dealer shall deliver to Counterparty the Share Termination Delivery Property on, or within a commercially reasonable period of time after, the date when the relevant Payment Obligation would otherwise be due pursuant to Section 12.7 or 12.9 of the Equity Definitions or Section 6(d)(ii) and 6(e) of the Agreement, as applicable, in satisfaction of such Payment Obligation in the manner reasonably requested by Counterparty free of payment. Share Termination Delivery Property: A number of Share Termination Delivery Units, as calculated by the Calculation Agent, equal to the Payment Obligation divided by the Share Termination Unit Price. The Calculation Agent shall adjust the Share Termination Delivery Property by replacing any fractional portion of a security therein with an amount of cash equal to the value of such fractional security based on the values used to calculate the Share Termination Unit Price.

  • Competitive integrated employment means work (including self-employment) that is performed on a full-time or part-time basis:

  • Child custody determination means a judgment, decree, or other order of a court providing for the legal custody, physical custody, or visitation with respect to a child. The term includes a permanent, temporary, initial, and modification order. The term does not include an order relating to child support or other monetary obligation of an individual.

  • Implementation Period means the period from the date of signing of the Agreement and up to the issuance of Final Acceptance Certificate for the project.

  • Change in Control Period means the time period commencing three (3) months before the effective date of a Change in Control and ending on the date that is twelve (12) months after the effective date of a Change in Control.

  • SOFR Determination Date has the meaning specified in the definition of “Daily Simple SOFR”.

  • Determination Period means the period from and including a Determination Date in any year to but excluding the next Determination Date; and