Delivery of Covered Services Clause Samples

Delivery of Covered Services. Covered Services will be delivered by teams (composed of physician assistants, nurses, nurse practitioners health coaches and medical assistants) led and overseen by a physician (collectively, “Provider(s)”). Health coaches may do the following: (a) conduct intake visits and work with physicians to create care plans; (b) provide education and coaching to patients both individually and in groups; (c) be accessible to patients by phone and email, with coverage arrangements for nights, weekends and holidays; (d) track the progress of patients in meeting their goals; and (e) proactively reach out to patients as needed.
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Delivery of Covered Services. (a) Provider/Patient Relationship. Provider shall observe, protect and promote the rights of Members as patients. Nothing contained in this Agreement shall be construed to limit or otherwise restrict Provider’s ethical and legal responsibility to fully advise Members about their medical condition and about medically appropriate treatment options.
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Delivery of Covered Services. (a) Beginning on the Effective Date, PA HRM shall assume the full risk and financial responsibility for the medical claim costs associated with the provision of all Covered Services pursuant to this Agreement. (b) Oxford Par Providers shall continue to be expected to provide Covered Services as and when required in accordance with general Oxford policies and procedures regarding the provision of Covered Services generally. Oxford Par Providers shall continue to be compensated for the provision of such services in accordance with their Oxford Par Provider Agreement. Oxford shall not have financial responsibility for the cost of any medical services from and after the Effective Date subject to Section 5.
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Delivery of Covered Services. Beginning no sooner than July 1, 2017, HCA shall provide Drug Medi-Cal Organized Delivery System (DMC-ODS) substance use disorder (SUD) services in accordance with the intergovernmental contract between the State Department of Health Care Services and the County of Orange. HCA has agreed to: Amendment I to the MOU for the Coordination of Mental Health Services_Medi-Cal • Maintain a provider network of County and contracted programs sufficient to meet the needs of the Members, with acknowledgement that the following services are benefits outside of DMC-ODS: o medically monitored intensive inpatient services are the responsibility of HCA; o medically managed intensive inpatient services in an acute care hospital, for which CalOptima would provide referral coordination and care, are the responsibility of CalOptima; and o voluntary inpatient detoxification (VID) services in an acute care hospital are Medi-Cal fee for service benefits. • Continually monitor and provide oversight to the DMC provider network to ensure Member access to quality SUD care. HCA will ensure the delivery of SUD services are within the scope of the SUD providers’ scope of practice.
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Related to Delivery of Covered Services

  • Provision of Covered Services MCP is responsible for authorizing Medically Necessary Covered Services, including NSMHS, ensuring MCP’s Network Providers coordinate care for Members as provided in the applicable Medi-Cal Managed Care Contract, and coordinating care from other providers of carve-out programs, services, and benefits.

  • Transportation Services i) In the event that transportation services for a student served by CONTRACTOR pursuant to an Individual Services Agreement are to be provided by a party other than CONTRACTOR or the LEA or its transportation providers, such services shall be reflected in a separate agreement signed by the parties hereto, and provided to the LEA and SELPA Director by the CONTRACTOR. Except as provided below, CONTRACTOR shall compensate the transportation provider directly for such services, and shall charge the LEA for such services at the actual and reasonable rates billed by the transportation provider, plus a ten percent (.

  • Related Services Licensee shall be responsible for obtaining and installing all proper hardware and support software (including operating systems) and for proper installation and implementation of and training concerning the Licensed Software. In the event that Licensee retains Licensor to perform any services with respect to the Licensed Software (for example: installation, implementation, maintenance, consulting and/or training services), Licensee and Licensor agree that such services shall be subject to Licensor’s then current standard terms, conditions and rates for such services unless otherwise agreed in writing by Licensor.

  • Covered Services You will receive Covered Services under the terms and conditions of this Contract only when the Covered Service is: • Medically Necessary; • Provided by a Participating Provider for in-network coverage; • Listed as a Covered Service; • Not in excess of any benefit limitations described in the Schedule of Benefits section of this Contract; and • Received while Your Contract is in force.

  • Contract for Professional Services of Physicians, Optometrists, and Registered Nurses In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government Code, Section 2254.008(a)(2) is applicable to this Contract, Contractor affirms that it possesses the necessary occupational licenses and experience.