Coverage and Services Sample Clauses
The "Coverage and Services" clause defines the scope of services or benefits that are provided under an agreement or policy. It typically outlines what specific services, products, or protections are included, and may detail any limitations, exclusions, or conditions that apply. For example, in an insurance contract, this clause would specify which types of incidents or losses are covered and which are not. Its core function is to set clear expectations for both parties, reducing misunderstandings and disputes about what is or is not included under the agreement.
Coverage and Services. Each MCP’s case management data submissions will be assessed for completeness and accuracy. The MCP is responsible for submitting a case management file every month. Failure to do so jeopardizes the MCP’s ability to demonstrate compliance with CSHCN requirements. For detailed descriptions of the case management measures below, see ODJFS Methods for Case Management Data Quality Measures.
Coverage and Services. The MCO must post prominent, easily understood information on its website for members and providers regarding the optimization of pregnancy outcomes. The MCO must include information for providers, trusted messengers (i.e., community health workers), and members about the prevention of preterm birth by linking to the Ohio Perinatal Quality Collaborative's information about best practices at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇▇/prematurity- prevention?adlt=strict.. The MCO must include a link to the official ODM notification of pregnancy and risk assessment form (PRAF 2.0) located at ▇▇▇▇▇://▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇▇▇▇▇▇▇▇▇.▇▇▇/login with a statement encouraging network providers to complete and submit the form to assist pregnant women in maintaining Medicaid eligibility and connecting to needed services and supports (e.g., home visiting). The MCO must post on its website the MCO's criteria for medical necessity determinations for services requiring authorization. In accordance with 42 CFR 438.915(a), the MCO must provide a hard copy of the MCO's medical necessity criteria to providers and members upon request. The MCO must receive prior written approval from ODM before adding any information to its website that would require ODM's prior approval in hard copy form (e.g., member handbook information). The MCO must include additional information on its website as determined necessary by ODM.
Coverage and Services. The MCO must post prominent, easily understood information on its website for members and providers regarding the optimization of pregnancy outcomes. The MCO must include information for providers, trusted messengers (i.e., community health workers), and members about the prevention of preterm birth through the use of progesterone treatment by linking to the Ohio Perinatal Quality Collaborative's information about progesterone best practices at ▇▇▇▇▇://▇▇▇.▇▇▇▇.▇▇▇/prematurity-prevention?adlt=strict and the Ohio Department of Health's progesterone-messaging toolkit located at ▇▇▇▇://▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. The MCO must include a link to the official ODM notification of pregnancy and risk assessment form (PRAF 2.0) located at ▇▇▇▇▇://▇▇▇▇▇▇▇▇.▇▇▇▇.▇▇▇/Provider/PRAF with a statement encouraging network providers to complete and submit the form to assist pregnant women in maintaining Medicaid eligibility and connecting to needed services and supports (e.g., home visiting). The MCO must post on its website the MCO's criteria for medical necessity determinations for services requiring authorization. In accordance with 42 CFR 438.915(a), the MCO must provide a hard copy of the MCO's medical necessity criteria to providers and members upon request. The MCO must receive prior written approval from ODM before adding any information to its website that would require ODM's prior approval in hard copy form (e.g., member handbook information). The MCO must include additional information on its website as determined necessary by ODM.
Coverage and Services can be adversely affected by radio interference, atmospheric conditions, geographic factors, network congestion, planned and/or unplanned maintenance works, outages on other networks and providers' sites, the configuration or limitations of the Customer’s recipient, Mobile Device or other operational or technical difficulties which means that You may not receive some or all of the Services in certain areas or at certain times. Coverage and Services can also change with network expansion or reconfiguration. In all aforementioned cases, We will not be liable to pay compensation to the Customer for any loss or damage resulting directly or indirectly because or from the interruption or breakdown of the Services for whatever reason.
Coverage and Services. (a) While we will do our best to provide quality services, because of the nature of telecommunications, it is impossible to guarantee a fault-free Service, as the quality and coverage of the Services depends partly on our network, and partly on other Telecommunications Service Providers to which our Services are connected.
(b) You agree • To keep any password, PIN number or security code that relates to the Services confidential, and to change any of the same if we request that you do so; • To notify us immediately if you believe that someone else has discovered your password, PIN number or security code, or has made fraudulent use of the Services
(c) You must remove your email from our mail server promptly, and keep space used by your files to a reasonable level. If you do not regularly remove your emails, or it builds up to an unreasonable level, we may remove it ourselves.
(d) The Services have free, mandatory virus and spam filtering activated on them, which prevent our mail servers from forwarding contaminated or spam- generated emails to the recipient. However, we cannot guarantee that the Services will prevent every virus or spam item being forwarded, and it will not filter out any virus or spam that do not pass through our mail servers. As such, we recommend that you install current anti- virus software and run regular scans of your computer.
(e) You agree that you will not use the Services: • in a way which breaks any law or infringes anyone’s legal rights; • to obtain unauthorised access to anyone’s computer or communications equipment; • to annoy anyone or to interfere with anyone else’s use of our Services.
(f) We reserve the right to remove any material from our servers which we consider, in our reasonable opinion, to breach the terms of this Agreement or any law.
(g) The Services may be changed, modified, advanced, suspended or removed by us. We will notify you before doing this, or introducing substitute or new services in accordance with paragraphs 18 and 21 below. If any of our new Services require new or upgraded equipment, you will be responsible for obtaining that equipment.
(h) You acknowledge that we do not support Voice over Internet protocol (“VoIP”) and that we can provide no assurance that currently available access levels may be maintained.
(i) You agree to follow our instructions about the use of the Services and ensure that all Users meet your responsibilities when using your Service. You agree to keep us protected against any ...
Coverage and Services. Basic Benefit Package
Coverage and Services. CFC ELIGIBLE POPULATION
Coverage and Services. Each MCP’s screening, assessment, and case management data submissions will be assessed for completeness and accuracy. The MCP is responsible for submitting a screening and assessment file (see Section 1 .b. of Appendix M, Performance Evaluation, for exceptions to this requirement) and a case management file every month. Failure to do so jeopardizes the MCP’s ability to demonstrate compliance with CSHCN requirements. For detailed descriptions of the screening, assessment, and case management measures below, see ODJFS Methods for Screening, Assessment, and Case Management Data Quality Measures. Appendix L
Coverage and Services can be adversely affected by radio interference, atmospheric conditions, geographic factors, network congestion, maintenance, outages on other networks and providers sites, the configuration or limitations of the Customer recipient's, Mobile Device or other operational or technical difficulties which means that you may not receive some or all of the Services in certain areas or at certain times. Coverage and Services can also change with network expansion or reconfiguration. We may, from time to time, disconnect the Service or Services for a short period to perform maintenance and repair work. In all aforementioned cases We will not be liable to pay compensation to the Customer for any loss or damage resulting directly or indirectly because or from the interruption or breakdown of the Services for whatever reason.
Coverage and Services i. Applies to Covered Items where Accidental Damage Coverage or Wear and Tear Coverage is applicable.
ii. ZucoraHome will attempt to assist with removing stains using professional stain removal products at no cost to the Member, or by providing professional cleaning services technician to remove the stains (requires a Trade Service Fee to be paid in advance of dispatching a technician).
iii. In the event ZucoraHome determines a repair or replacement parts are required, ZucoraHome shall obtain the required replacement parts at no cost to the Member and provide a professional repair technician, at no cost the Member, to inspect, repair and/or replace the failed part or components (requires a Trade Service Fee to be paid in advance of dispatching a technician).
iv. In the event ZucoraHome determines, in its sole discretion, that the Covered Item(s) require replacement and where the Member has provided to ZucoraHome, a copy of the invoice issued by the Retailer which includes the Covered Item description, item price (“Purchase Price”) and date of purchase of the Covered Item(s); or where ZucoraHome determines the approximate Purchase Price of the Covered Item; ZucoraHome may elect to issue to the Member, a Gift Card or reimbursement in cash, such method of payment as determined by ZucoraHome, with the amount calculated on a pro- rata basis of the value of the actual or estimated Purchase Price (not including taxes, delivery or other charges) as follows: First 12 months following date of purchase 100% of Purchase Price 50% of Purchase Price 13th month to 24th month following date of purchase 80% of Purchase Price 40% of Purchase Price 25th month to 36th month following date of purchase 40% of Purchase Price 20% of Purchase Price 37th month to 48th month following date of purchase 20% of Purchase Price 10% of Purchase Price 49th month and thereafter, following date of purchase 10% of Purchase Price 5% of Purchase Price