Access to Services for Emergency Conditions and Urgent Care Sample Clauses

Access to Services for Emergency Conditions and Urgent Care. The Contractor must ensure access to twenty-four (24) hour emergency services for all Enrollees, whether they reside in institutions or in the community.
View SourceView Similar (7)
Access to Services for Emergency Conditions and Urgent Care. The Contractor must ensure access to 24-hour emergency services for all Enrollees, whether they reside in institutions or in the community. a. When service for an Emergency Condition is required, the Contractor must have a process established to notify the PCP or PCT (or the designated covering physician) within one business day after the Contractor is notified by the Provider. If the Contractor is not notified by the Provider within 10 calendar days of the Enrollee’s presentation for emergency services, the Contractor is not responsible for payments; b. When Urgent Care is required, the Contractor must have a process to notify the PCP or PCT within 24 hours after the Contractor is notified; c. Summary information about Emergency Conditions and Urgent Care services provided must be recorded in the Centralized Enrollee Record no more than 18 hours after the PCP or PCT is notified, and a full report of the services provided within two business days; d. If services are obtained out of network for Emergency Conditions, the Contractor must pay the Provider or reimburse the Enrollee, in the fee-for-service amount that would have been paid by Medicare or MassHealth, within 60 calendar days after the claim has been submitted; and e. The Contractor must cover and pay for any services obtained for Emergency Conditions in accordance with 42
View Source

Related to Access to Services for Emergency Conditions and Urgent Care

  • CONDITIONS FOR EMERGENCY/HURRICANE OR DISASTER - TERM CONTRACTS It is hereby made a part of this Invitation for Bids that before, during and after a public emergency, disaster, hurricane, flood, or other acts of God that Orange County shall require a “first priority” basis for goods and services. It is vital and imperative that the majority of citizens are protected from any emergency situation which threatens public health and safety, as determined by the County. Contractor agrees to rent/sell/lease all goods and services to the County or other governmental entities as opposed to a private citizen, on a first priority basis. The County expects to pay contractual prices for all goods or services required during an emergency situation. Contractor shall furnish a twenty-four (24) hour phone number in the event of such an emergency.

  • Interconnection Customer Compensation for Actions During Emergency Condition The CAISO shall compensate the Interconnection Customer in accordance with the CAISO Tariff for its provision of real and reactive power and other Emergency Condition services that the Interconnection Customer provides to support the CAISO Controlled Grid during an Emergency Condition in accordance with Article 11.6.

  • Important Information About Procedures for Opening a New Account To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial organizations to obtain, verify, and record information that identifies each person who opens an account. Therefore, when you open a ▇▇▇▇ ▇▇▇, you are required to provide your name, residential address, date of birth, and identification number. We may require other information that will allow us to identify you.

  • Modifications to service This Auction Site reserves the right to modify or discontinue the Service with or without notice to user. This Auction Site shall not be liable to users or any third party should this Auction Site exercise its right to modify or discontinue the Service.

  • Developer Compensation for Emergency Services If, during an Emergency State, the Developer provides services at the request or direction of the NYISO or Connecting Transmission Owner, the Developer will be compensated for such services in accordance with the NYISO Services Tariff.