Eligibility Verification (a) HHSC will verify Medicaid eligibility for Dual Eligible Members by the fifth business day of the month following the receipt of the MA Dual SNP’s monthly enrollment file, in accordance with Section 3.02(b).
(b) To verify Medicaid eligibility of an individual Member, HHSC agrees to provide the MA Dual SNP with real-time access to HHSC’s claims administrator’s Medicaid eligibility verification system.
Electronic Visit Verification ("EVV A. To ensure:
1. the EVV system is used to verify the provision of services governed under 40 TAC, Chapter 68 or its successor;
2. only authorized people access the Contractor's EVV account;
3. all data elements required by HHSC or HHSC's designee are uploaded or entered and maintained in the EVV system completely, accurately, and prior to submitting the claim;
4. that each time services governed by 40 TAC Chapter 68 or its successor are delivered to an individual, the Contractor's staff uses an HHSC-approved EVV system; and
5. service delivery documentation is immediately available for review by HHSC when requested.
B. Equipment provided to Contractor by HHSC, HHSC’s designee, or an HHSC-approved EVV vendor, must be returned in good condition when the equipment is no longer needed under this Contract. In the context of this agreement, “good condition” means Contractor must not place any marks or identifying information on the equipment and may not alter information on the equipment including logos and serial numbers. If the equipment is lost, stolen, marked, altered or damaged by Contractor, Contractor may be required to pay the replacement cost for each piece of equipment that is lost, stolen, marked or damaged. Replacement costs for lost, stolen, marked or damaged equipment may be assessed periodically. If Contractor recovers previously lost or stolen equipment for which Contractor paid the replacement cost in the prior 12 months, Contractor may return the equipment and be reimbursed for the replacement costs within 12 months of the date HHSC, HHSC’s designee or an HHSC-approved EVV vendor (as applicable) received payment in full from the Contractor. This is provided the equipment is returned in good condition as specified above.
C. HHSC may perform EVV compliance oversight reviews to determine if Contractor has complied with EVV compliance requirements as outlined in 40 TAC Chapter 68 or its successor, EVV Policy posted on the HHSC EVV website or EVV Policy Handbook.
D. If the Contractor determines an electronic record in the EVV system needs to be adjusted at any time, the Contractor will make the adjustment in the EVV system using the most appropriate EVV reason code number(s), EVV reason code description(s) and enter any required free text when completing visit maintenance in the EVV system, if applicable.
E. Contractor must begin using an HHSC-approved EVV system prior to submitting an EVV relevant claim.
F. All claims for services required to use EVV (EVV claims) must match to an accepted EVV visit transaction in the EVV Aggregator (the state’s centralized EVV database) prior to reimbursement of an EVV claim. Without a matching accepted EVV visit transaction, the claim will be denied.
G. Contractor must submit all EVV related claims through the Texas Medicaid Claims Administrator, or as otherwise described in the EVV Policy posted on the HHSC EVV website or in the EVV Policy Handbook.
H. Contractor must complete all required EVV training as outlined in the EVV Policy posted on the HHSC EVV website or EVV Policy Handbook: • Prior to using either an EVV vendor system or an EVV proprietary system and • Yearly thereafter.
I. Contractor and, if applicable, the Contractor’s appointed EVV system administrator, must complete, sign and date the EVV Onboarding Form as outlined in 40 TAC Chapter 68 or its successor, EVV Policy posted on the HHSC website or EVV Policy Handbook.
Disbursement Procedures The Issuing Bank shall, promptly following its receipt thereof, examine all documents purporting to represent a demand for payment under a Letter of Credit. The Issuing Bank shall promptly notify the Administrative Agent and the Borrower by telephone (confirmed by telecopy) of such demand for payment and whether the Issuing Bank has made or will make an LC Disbursement thereunder; provided that any failure to give or delay in giving such notice shall not relieve the Borrower of its obligation to reimburse the Issuing Bank and the Lenders with respect to any such LC Disbursement.
Search, Enquiry, Investigation, Examination And Verification a. The Property is sold on an “as is where is basis” subject to all the necessary inspection, search (including but not limited to the status of title), enquiry (including but not limited to the terms of consent to transfer and/or assignment and outstanding charges), investigation, examination and verification of which the Purchaser is already advised to conduct prior to the auction and which the Purchaser warrants to the Assignee has been conducted by the Purchaser’s independent legal advisors at the time of execution of the Memorandum.
b. The intending bidder or the Purchaser is responsible at own costs and expenses to make and shall be deemed to have carried out own search, enquiry, investigation, examination and verification on all liabilities and encumbrances affecting the Property, the title particulars as well as the accuracy and correctness of the particulars and information provided.
c. The Purchaser shall be deemed to purchase the Property in all respects subject thereto and shall also be deemed to have full knowledge of the state and condition of the Property regardless of whether or not the said search, enquiry, investigation, examination and verification have been conducted.
d. The Purchaser shall be deemed to have read, understood and accepted these Conditions of Sale prior to the auction and to have knowledge of all matters which would have been disclosed thereby and the Purchaser expressly warrants to the Assignee that the Purchaser has sought independent legal advice on all matters pertaining to this sale and has been advised by his/her/its independent legal advisor of the effect of all the Conditions of Sale.
e. Neither the Assignee nor the Auctioneer shall be required or bound to inform the Purchaser of any such matters whether known to them or not and the Purchaser shall raise no enquiry, requisition or objection thereon or thereto.
Determination to Honor Drawing Request In determining whether to honor any request for drawing under any Letter of Credit by the beneficiary thereof, Agent shall be responsible only to determine that the documents and certificates required to be delivered under such Letter of Credit have been delivered and that they comply on their face with the requirements of such Letter of Credit and that any other drawing condition appearing on the face of such Letter of Credit has been satisfied in the manner so set forth.