Administrative Performance Program Sample Clauses

The Administrative Performance Program clause establishes a framework for evaluating and managing the performance of administrative personnel within an organization. Typically, this clause outlines the criteria, metrics, and processes used to assess administrative staff, such as regular performance reviews, goal setting, and feedback mechanisms. By formalizing expectations and evaluation procedures, the clause helps ensure consistent performance standards and provides a basis for recognizing achievements or addressing underperformance, ultimately supporting organizational efficiency and accountability.
Administrative Performance Program. Valid Encounter Claims Data
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Administrative Performance Program a. The Administrative Performance (AP) Standard utilizes the AP Withhold (APW) methodology described in this section. The APW methodology requires the submission of Valid Encounter Data, including pharmacy claims data that is submitted to OHA and certified in accordance with OAR 410-141-3430 and that is also submitted to the All Payer All Claims database by OHA or by Contractor. OHA may provide further instructions about the APW process. The APW process will not alter OHA’s authority to administer the encounter data requirements of OAR 410-141-3430 or any other provisions under the Contract. b. For purposes of the APW methodology and calculations, the following definitions apply:
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Administrative Performance Program a. The Administrative Performance (AP) Standard utilizes the AP Penalty (APP) methodology described in this section. The APP methodology requires the submission of Valid Encounter Data, including pharmacy claims data that is submitted to OHA and certified in accordance with OAR 410-141-3430 and that is also submitted to the All Payer All Claims database by OHA or by Contractor. OHA may provide further instructions about the APP process. The APP process will not alter OHA’s authority to administer the encounter data requirements of OAR b. For purposes of the APP methodology and calculations: (1) All Valid Encounter Data, including Encounter Pharmacy Data, for a Subject Month must be submitted and accepted by OHA as meeting the AP Standard not later than the end of the Final Submission Month. (2) OHA will send Contractor a Subject Month report within 30 days after the end of the Final Submission Month. (3) If Contractor’s Valid Encounter Data submissions for the Subject Month are complete and meet the AP Standard, OHA will issue a final Subject Month report and no withhold will occur. (4) If Contractor’s Valid Encounter Data submissions for the Subject Month have not met the AP Standard, OHA will provide a proposed Subject Month report. The proposed report will become final for purposes of the APP calculations 15 days after the date of the report, unless OHA receives from Contractor a written notice of appeal for the applicable (5) Any appeal shall be conducted as an administrative review. The administrative review process will be conducted in the manner described in OAR 410-120-1580(4)-(6). Contractor understands and agrees that administrative review is the sole avenue for review of Subject Month reports for purposes of APP. The decision on administrative review shall result in a final Subject Month report if an appeal was timely filed. (6) OHA will rely upon the final report to determine whether the Contractor is subject to an AP Withhold for the Subject Month and the withhold amount. (7) If Contractor is subject to an AP Withhold pursuant to this section, after the conclusion of any appeal or the expiration of time to request an appeal, OHA will notify Contractor of the Withhold Month. In general, the AP Withhold for that Subject Month will be applied to the following calendar month’s Capitation Payment. (8) OHA will place AP Withhold amounts not paid to Contractor into an AP pool. The AP pool consists of all AP Withhold amounts that are not distributed t...
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Administrative Performance Program. Valid Encounter Claims Data‌ In order to ensure the integrity of the Medicaid program, OHA and CMS require compliance with a wide range of obligations relating to the verification of services provided to Members. One means by which compliance is verified is the collection and reporting data relating to claims for all services provided to Members, whether such claims are for Covered Services or other health-related services. Accordingly, Contractor is required, pursuant to 42 CFR §438.604, 42 CFR §438.606, and OAR 410-141-3430 to submit and certify to OHA the accuracy and truthfulness of Encounter Data, which is then subject to OHA for review and verification. In addition to ensuring the integrity of the Medicaid program, OHA also relies on Encounter Data to: (i) set Capitation Rates, (ii) calculate Quality Incentive Payments, and
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Related to Administrative Performance Program

  • Ongoing Performance Measures The Department intends to use performance-reporting tools in order to measure the performance of Contractor(s). These tools will include the Contractor Performance Survey (Exhibit G), to be completed by Customers on a quarterly basis. Such measures will allow the Department to better track Vendor performance through the term of the Contract(s) and ensure that Contractor(s) consistently provide quality services to the State and its Customers. The Department reserves the right to modify the Contractor Performance Survey document and introduce additional performance-reporting tools as they are developed, including online tools (e.g. tools within MFMP or on the Department's website).

  • CONTRACTOR PERFORMANCE AUDIT The Contractor shall allow the Authorized User to assess Contractor’s performance by providing any materials requested in the Authorized User Agreement (e.g., page load times, response times, uptime, and fail over time). The Authorized User may perform this Contractor performance audit with a third party at its discretion, at the Authorized User’s expense. The Contractor shall perform an independent audit of its Data Centers, at least annually, at Contractor expense. The Contractor will provide a data owner facing audit report upon request by the Authorized User. The Contractor shall identify any confidential, trade secret, or proprietary information in accordance with Appendix B, Section 9(a), Confidential/Trade Secret Materials.

  • Annual Performance Bonus During the Employment Term, the Executive shall be entitled to participate in the STIP, with such opportunities as may be determined by the Chief Executive Officer in his sole discretion (“Target Bonuses”), and as may be increased (but not decreased, except for across-the-board reductions generally applicable to the Company’s senior executives) from time to time, and the Executive shall be entitled to receive full payment of any award under the STIP, determined pursuant to the STIP (a “Bonus Award”).

  • Annual Performance Review The Employee’s performance of his duties under this Agreement shall be reviewed by the Board of Directors or a committee of the Board of Directors at least annually and finalized within thirty (30) days of the receipt of the annual audited financial statements. The Board of Directors or a committee of the Board of Directors shall additionally review the base salary, bonus and benefits provided to the Employee under this Agreement and may, in their discretion, adjust the same, as outlined in Addendum B of this Agreement, provided, however, that Employee’s annual base salary shall not be less than the base salary set forth in Section 4(A) hereof.

  • KEY PERFORMANCE INDICATORS 10.1 The Supplier shall at all times during the Framework Period comply with the Key Performance Indicators and achieve the KPI Targets set out in Part B of Framework Schedule 2 (Goods and/or Services and Key Performance Indicators).