Request for Additional Information Sample Clauses

Request for Additional Information. The Recommended Clinical Review process may require additional documentation from the Member’s health care provider or pharmacist. In addition to the written request for Recommended Clinical Review, the health care provider or pharmacist may be required to include pertinent documentation explaining the proposed services, the functional aspects of the treatment, the projected outcome, treatment plan and any other supporting documentation, study models, prescription, itemized repair and replacement cost statements, photographs, x-rays, etc., as may be requested by The Plan to make a determination of coverage pursuant to the terms and conditions of this Contract. Contacting Behavioral Health‌ The Member, the Member’s provider, or authorized representative may contact The Plan for a Prior Authorization or Recommended Clinical Review by calling the toll-free number shown on the back of the Member’s identification card and follow the prompts to the behavioral health unit. During regular business hours (7:00 a.m. and 5:00 p.m., Mountain Time, on business days), the caller will be routed to the appropriate behavioral health clinical team for review. Outpatient requests should be requested during regular business hours. After 5:00 p.m., on weekends, and on holidays, the same behavioral health line is answered by clinicians available for inpatient acute Recommended Clinical Reviews only. Requests for residential or Partial Hospitalization are reviewed during regular business hours. Post-Service Medical Necessity Review‌ A Post-Service Medical Necessity Review, sometimes referred to as a retrospective review or post-service claims request, is the process of determining coverage after treatment has been provided and is based on Medical Necessity guidelines. A Post-Service Medical Necessity Review confirms Member eligibility, availability of Benefits at the time of service, and reviews necessary clinical documentation to ensure the service was Medically Necessary. Providers should submit appropriate documentation at the time of a post-service review request. A Post-Service Medical Necessity Review may be performed when a Prior Authorization or Recommended Clinical Review was not obtained prior to services being rendered.

Request for Additional Information. The Post-Service Medical Necessity Review process may require additional documentation from Your health care Provider or pharmacist. In addition to the written request for Post-Service Medical Necessity Review, the health care Provider or pharmacist may be required to include pertinent documentation explaining the services rendered, the functional aspects of the treatment, the projected outcome, treatment plan and any other supporting documentation, study models, prescription, itemized repair and replacement cost statements, photographs, x-rays, etc., as may be requested by the plan to make a determination of coverage pursuant to the terms and conditions of HMO.

Request for Additional Information. The Post-Service Medical Necessity Review process may require additional documentation from the Member’s health care provider or pharmacist. In addition to the written request for Post-Service Medical Necessity Review, the health care provider or pharmacist may be required to include pertinent documentation explaining the services rendered, the functional aspects of the treatment, the projected outcome, treatment plan and any other supporting documentation, study models, prescription, itemized repair and replacement cost statements, photographs, x-rays, etc., as may be requested by The Plan to make a determination of coverage pursuant to the terms and conditions of this Contract. Care Management‌ The goal of Care Management is to help the Member receive the most appropriate care that is also cost effective. If the Member has an ongoing medical condition or a catastrophic Illness, the Member should contact The Plan. If appropriate, a care manager will be assigned to work with the Member and the Member’s providers to facilitate a treatment plan. Care Management includes Member education, referral coordination, utilization review and individual care planning. Involvement in Care Management does not guarantee payment by The Plan. To be eligible for enrollment, the applicant must and any Dependents for whom coverage is sought must: 1. Be a resident of the state of Montana; and 2. Complete an application. Eligibility for this coverage will be determined by the Exchange in accordance with applicable law. For questions regarding eligibility, refer to ▇▇▇▇▇▇▇▇▇▇.▇▇▇. Applying for Coverage‌ An applicant may apply for coverage in a Qualified Health Plan (QHP) through the Exchange for himself/herself and/or any eligible Dependents (see below) by submitting the application(s) for individual medical insurance form, along with any exhibits, appendices, addenda and/or other required information (“application(s)”) to Blue Cross and Blue Shield of Montana and the Exchange, as appropriate. The application(s) for coverage may or may not be accepted. No eligibility rules or variations in premium will be imposed based on health status, medical condition, claims experience, receipt of healthcare, medical history, genetic information, evidence of insurability, disability, or any other health status related factor. Applicants will not be discriminated against for coverage under this Plan on the basis of race, color, national origin, disability, age, sex, gender identity, or sexual o...

Request for Additional Information. Effective Date: 12/26/2014 Within 10 working days after an applicant receives notice that USAID will not fund its application, the unsuccessful applicant may send a written request for additional information to the AO. Additional information may be provided at the discretion of the AO. USAID may respond orally or in writing. The cognizant B/IO should respond to the request within 30 days after consultation with the AO or inform the applicant that more time is necessary. If responding orally, the AO or the technical representative from the B/IO must make a written summary of the response for the agreement file. The AO must be present at and lead any meeting. If responding in writing, the AO must approve any written communication before it is sent to the unsuccessful applicant. USAID’s responses must be limited to the Agency’s interest in supporting the applicant’s program as described in the application. Comparing one application to another is neither advisable nor helpful to the applicant. The Selection Committee (SC) chair and the AO should only give additional information that would be useful to the applicant in preparing future applications. If the applicant has questions about the program or about the programmatic review, the SC chair will provide constructive feedback that may assist the applicant when developing applications in the future. The SC chair may explain the basis for the decision and the strengths and weaknesses of the application in terms of the published review criteria. When the applicant has questions about process, accountability, and business considerations, the AO will respond. The SC chair and the AO will jointly respond when the applicant raises both types of questions.

Request for Additional Information. 1. Pursuant to Section 2-11.1(t) of the Code of Miami-Dade County, all Solicitations, once advertised and until an award recommendation are under the “Cone of Silence.” Any communication or inquiries, except for clarification of process or procedure already contained in the Solicitation, are to be made in writing to the attention of the Procurement Contracting Officer identified on the front page of the Solicitation via INFORMS with a copy sent to the Clerk of the Board, ▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇.▇▇▇. 2. SPD may issue an addendum in response to any inquiry received, prior to Bid opening, which changes, adds to, or clarifies the terms, provisions or requirements of the Solicitation. The Bidder should not rely on any representation, statement, or explanation whether written or verbal, other than those made in this Solicitation document or in any addenda issued. 3. It is the Bidder’s responsibility to ensure receipt of all addenda, and

Request for Additional Information. Pursuant to Section 2-11.1(t) of the County Code, this RFQ is subject to the “Cone of Silence” until an award recommendation has been made. Any communication or inquiries, except for clarification of process or procedure already contained in the solicitation, are to be made in writing to the attention of the contact person identified on the front page of the solicitation. Such inquiries or requests for information shall be submitted to the departmental contact person in writing and shall contain the requester’s name, address, and telephone number. If transmitted by facsimile, the request should also include a cover sheet with Bidder’s facsimile number. The requestor must also file a copy of this written request with the Clerk of the Board, ▇▇▇ ▇▇ ▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇-1983 or email ▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇.▇▇▇.

Request for Additional Information. The Recommended Clinical Review process may require additional documentation from Your Provider or pharmacist. In addition to the written request for Recommended Clinical Review, the Provider or pharmacist may be required to include pertinent documentation explaining the proposed services, the functional aspects of the treatment, the projected outcome, treatment plan and any other supporting documentation, study models, prescription, itemized repair and replacement cost statements, photographs, x-rays, etc., as may be requested by BCBSTX to make a determination of coverage pursuant to the terms and conditions of this Plan.

Request for Additional Information. The Client shall promptly provide to the Custodian such additional information as the Custodian may request regarding the source or ownership of the Eligible Assets that are subject to a Digital Asset Credit Request or the recipient of Eligible Assets (and any associated financial institution) that are the subject of a Digital Asset Debit Request.

Request for Additional Information. 1. If there is doubt about the validity or authenticity of a FLEGT licence, a duplicate or a replacement FLEGT licence, the competent authorities may request additional information from the licensing authority. 2. A copy of the FLEGT licence, the duplicate or the replacement FLEGT licence in question may be forwarded together with the request. 3. If necessary, the FLEGT licensing authority shall withdraw the FLEGT licence and issue a corrected copy authenticated by the stamped endorsement “Duplicate” and forward it to the competent authority.