Eligibility and Enrollment Data Exchange Requirements Sample Clauses

Eligibility and Enrollment Data Exchange Requirements a. The Health Plan shall receive, process and update enrollment files sent daily by the Agency or its Agent. b. The Health Plan shall update its eligibility/Enrollment databases within twenty-four (24) hours of receipt of said files. c. The Health Plan shall transmit to the Agency or its Agent, in a periodicity schedule, format and data exchange method to be determined by the Agency, specific data it may ▇▇▇▇▇▇ from an Enrollee including third party liability data. d. The Health Plan shall be capable of uniquely identifying a distinct Medicaid Recipient across multiple Systems within its Span of Control.
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Eligibility and Enrollment Data Exchange Requirements a. The Health Plan shall receive, process and update enrollment files sent daily by the Agency or its agent. b. The Health Plan shall update its eligibility/enrollment databases within twenty-four (24) hours after receipt of said files. c. The Health Plan shall transmit to the Agency or its agent, in a periodicity schedule, format and data exchange method to be determined by the Agency, specific data it may ▇▇▇▇▇▇ from an enrollee including third party liability data. d. The Health Plan shall be capable of uniquely identifying a distinct Medicaid recipient across multiple systems within its span of control. AMERIGROUP Florida, Inc. d/b/a Medicaid Non-Reform and Reform AMERIGROUP Community Care HMO Contract
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Eligibility and Enrollment Data Exchange Requirements. 2.23.5.1 The CONTRACTOR shall receive, process and update enrollment files sent daily by TENNCARE. 2.23.5.2 The CONTRACTOR shall update its eligibility/enrollment databases within twenty-four (24) hours of receipt of said files. 2.23.5.3 The CONTRACTOR shall transmit to TENNCARE, in the formats and methods specified in the HIPAA Implementation and TennCare Companion guides or as otherwise specified by TENNCARE: member address changes, telephone number changes, and PCP. 2.23.5.4 The CONTRACTOR shall be capable of uniquely identifying a distinct TennCare member across multiple populations and Systems within its span of control. 2.23.5.5 The CONTRACTOR shall be able to identify potential duplicate records for a single member and, upon confirmation of said duplicate record by TENNCARE, and resolve the duplication such that the enrollment, service utilization, and customer interaction histories of the duplicate records are linked or merged.
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Eligibility and Enrollment Data Exchange Requirements a. The Health Plan shall receive, process and update enrollment files sent daily by the Agency or its agent. b. The Health Plan shall update its eligibility/enrollment databases within twenty-four (24) hours after receipt of said files. c. The Health Plan shall transmit to the Agency or its agent, in a periodicity schedule, format and data exchange method to be determined by the Agency, specific data it may ▇▇▇▇▇▇ from an enrollee including third party liability data. d. The Health Plan shall be capable of uniquely identifying a distinct Medicaid recipient across multiple systems within its span of control. HealthEase of Florida, Inc. Medicaid HMO Non-Reform Contract 1. Availability of Critical Systems Functions
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Related to Eligibility and Enrollment Data Exchange Requirements

  • Open Enrollment KFHPWA will allow enrollment of Subscribers and Dependents who did not enroll when newly eligible as described above during a limited period of time specified by the Group and KFHPWA.

  • Credentialing Requirements Registry Operator, through the facilitation of the CZDA Provider, will request each user to provide it with information sufficient to correctly identify and locate the user. Such user information will include, without limitation, company name, contact name, address, telephone number, facsimile number, email address and IP address.

  • Child Abuse Reporting Requirements A. Grantees shall comply with child abuse and neglect reporting requirements in Texas Family Code Chapter 261. This section is in addition to and does not supersede any other legal obligation of the Grantee to report child abuse. B. Grantee shall use the Texas Abuse Hotline Website located at ▇▇▇▇▇://▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇/Login/Default.aspx as required by the System Agency. Grantee shall retain reporting documentation on site and make it available for inspection by the System Agency.

  • Testing Requirements 12.1. Workplaces - 12.2. On workplaces where the value of the Commonwealth’s contribution to the project that includes the building work is at least $5,000,000, and represents at least 50% of the total construction project value or the Commonwealth’s contribution to the project that includes the building work is at least $10,000,000 (irrespective of its proportion of the total construction project value) the following minimum testing requirements must be adhered to.

  • Enrollment Requirements You must maintain with Blue Cross and Blue Shield a current and updated listing of covered employees. You will be responsible for all claims costs and expenses associated with failure to maintain an accurate and current listing with Blue Cross and Blue Shield, unless such claims costs and expenses are due to an error on Blue Cross and Blue Shield’s part. In order to maintain health care coverage with Blue Cross and Blue Shield, an employee must meet the written eligibility requirements (such as length of service, active employment and number of hours worked) you impose as long as they do not conflict with Blue Cross and Blue Shield’s eligibility requirements. An eligible employee as defined by Blue Cross and Blue Shield means: • A permanent full-time employee regularly working 30 hours or more each week at the employer’s usual place(s) of business and who is paid a salary or wage in accordance with state and federal wage requirements; or • A permanent part-time employee regularly working at least 20 hours but less than 30 hours each week at the employer’s usual place(s) of business and who is paid a salary or wage in accordance with state and federal wage requirements; or • A disabled permanent full-time or part-time employee who is actively working despite the disability (including one who is engaged in a trial work period) and a disabled employee who is not actively working but whom the employer treats as an employee; or • A former employee (or a former covered dependent of the employee of the group) who qualifies for continued group coverage under federal or state law, but only if the employer maintains Blue Cross and Blue Shield group coverage for permanent full-time employees as defined in (a) above; or • A retired employee of the employer. Newly hired employees who are eligible for group benefits can enroll in the benefits plan according to your eligibility requirements for coverage, provided that your requirements comply with Blue Cross and Blue Shield’s eligibility and enrollment requirements. The effective date of an eligible employee’s (or his or her dependent’s) membership in the benefits plan may be the Member’s initial eligibility date or your subsequent anniversary/renewal date, as long as: (a) Blue Cross and Blue Shield receives your written notice no later than 30 days after the Member’s enrollment notification period applicable to membership modifications (as described in the Subscriber Certificate for your benefits plan); and (b) you pay the applicable premium charges.