Scope of Covered Services Clause Samples
The "Scope of Covered Services" clause defines the specific services that a provider is obligated to deliver under an agreement. It typically outlines the types of work, deliverables, or activities included, and may also clarify what is excluded from the provider's responsibilities. By clearly delineating what is and is not covered, this clause helps prevent misunderstandings and disputes about service expectations, ensuring both parties have a mutual understanding of the contractual obligations.
Scope of Covered Services. (A) Except as otherwise provided for cases of Emergency Services, the Contractor is responsible to arrange for all Covered Services listed in the State’s Prepaid Mental Health Plan Waiver
(B) The Contractor is responsible for payment of Emergency Services 24 hours a day, 7 days a week whether the services were provided by a Network Provider or a Non-Network Provider and whether the service was provided inside or outside of the Contractor’s Service Area.
(C) In addition to services covered under the State Plan, or the State’s Prepaid Mental Health Plan Waiver, the Contractor may cover services necessary for compliance with the requirements of subpart K of 42 CFR § 438 only to the extent such services are necessary for compliance with 42 CFR § 438.910.
(D) The services provided by the Contractor shall be delivered in compliance with the requirements of subpart K of 42 CFR § 438 insofar as applicable.
(E) The Contractor shall provide the Department with non-quantitative treatment limitation assessment tools, surveys or any corrective action plans related to compliance with the Mental Health Parity and Addiction Equity Act of 2008 and all related regulations as requested by the Department within the timeframes requested by the Department.
Scope of Covered Services. (A) The Contractor is responsible to arrange for all Covered Services listed in State’s Prepaid Mental Health Plan Waiver.
(B) The Contractor is responsible for payment of Emergency Services 24 hours a day, 7 days a week whether the services were provided by a Participating Provider or a Non-Participating Provider and whether the service was provided inside or outside of the Contractor’s Service Area.
Scope of Covered Services. (A) Except as otherwise provided for cases of Emergency Services, the Contractor is responsible to arrange for all Covered Services listed in the State’s Prepaid Mental Health Plan Waiver, unless otherwise stated in this Contract.
(B) The Contractor is responsible for payment of Emergency Services 24 hours a day, 7 days a week, whether the services were provided by a Network Provider or a Non-Network Provider, and whether the service was provided inside or outside of the Contractor’s Service Area.
(C) In addition to services covered under the State Plan, or the State’s Prepaid Mental Health Plan Waiver, the Contractor may cover services necessary for compliance with the requirements of subpart K of 42 CFR § 438 only to the extent such services are necessary for compliance with 42 CFR § 438.910.
(D) The services provided by the Contractor shall be delivered in compliance with the requirements of subpart K of 42 CFR § 438 insofar as applicable.
(E) The Contractor shall provide the Department with non-quantitative treatment limitation assessment tools, surveys or any corrective action plans related to compliance with the Mental Health Parity and Addiction Equity Act of 2008 and all related regulations as requested by the Department within the timeframes requested by the Department.
Scope of Covered Services. (A) The Contractor is responsible to arrange for all Covered Services listed in State’s Prepaid Mental Health Plan Waiver.
(B) The Contractor is responsible for payment of Emergency Services 24 hours a day, 7 days a week whether the services were provided by a Network Provider or a Non-Network Provider and whether the service was provided inside or outside of the Contractor’s Service Area.
(C) In addition to services covered under the State Plan or the State’s Prepaid Mental Health Plan Waiver, the Contractor may cover services necessary for compliance with the requirements of subpart K of 42 CFR Part 438 only to the extent such services are necessary for compliance with 42 CFR 438.910.
(D) The services provided by Contractor shall be delivered in compliance with the requirements of Subpart K of 42 CFR Part 438 insofar as applicable.
(E) The Contractor shall provide the Department with non-quantitative treatment limitation assessment tools, surveys or any corrective action plans related to compliance with the Mental Health Parity and Addiction Equity Act of 2008 and all related regulations as requested by the Department within the timeframes requested by the Department.
Scope of Covered Services. (A) Except as otherwise provided for by this contract, the Contractor is responsible to arrange for all dental Covered Services listed in the State Plan and as outlined in Attachment C.
(B) In accordance with 42 CFR 438.210 the Contractor shall administer Covered Services, when Medically Necessary, in a manner that takes into account the following:
(1) services that address the prevention, diagnosis, and treatment of an Enrollee's disease, condition, and/or disorder that results in health impairments and/or disability;
(2) the ability for an Enrollee to achieve age-appropriate growth and development;
(3) the ability for an Enrollee to attain, maintain, or regain functional capacity
(C) The services provided by Contractor shall be delivered in compliance with the requirements of Subpart K of 42 CFR Part 438 insofar as applicable.
Scope of Covered Services. (A) Except as otherwise provided for cases of Emergency Services, the Contractor is responsible to pay for all Covered Services listed in Attachment C. The Contractor shall also be responsible to pay for Covered Services that are, subsequent to the execution of this contract, deemed Covered Services due to amendments, revisions, or additions to the CHIP State Plan or to State or Federal regulations, guidelines or policies or made pursuant to court or administrative orders.
(B) The Contractor shall ensure that services are sufficient in amount, duration or scope to reasonably be expected to achieve the purpose for which the services are furnished.
(C) The Contractor may not arbitrarily deny or reduce the amount, duration, or scope of a required service solely because of diagnosis, type of illness, or condition of the Enrollee.
(D) The Contractor is responsible for payment of Emergency Services 24 hours a day, 7 days a week whether the services were provided by a Participating Provider or a Non-Participating Provider and whether the service was provided inside or outside of the Contractor’s Service Area.
Scope of Covered Services. (A) Except as otherwise provided for cases of Emergency Services, the Contractor is responsible to pay for all Covered Services listed in Attachment C. The Contractor shall also be responsible to pay for Covered Services that are, subsequent to the execution of this contract, deemed Covered Services due to amendments, revisions, or additions to the CHIP State Plan or to State or Federal regulations, guidelines or policies or made pursuant to court or administrative orders.
(B) In accordance with 42 CFR 438.210 the Contractor shall administer Covered Services, when Medically Necessary, in a manner that takes into account the following:
(1) services that address the prevention, diagnosis, and treatment of an Enrollee's disease, condition, and/or disorder that results in health impairments and/or disability;
(2) the ability for an Enrollee to achieve age-appropriate growth and development;
(3) the ability for an Enrollee to attain, maintain, or regain functional capacity
Scope of Covered Services. Healing Together provides individual, couples and family talk therapy, including therapy for minor children.
1. Client understands and agrees that there are risks and benefits associated with the various treatment choices for his or her Minor. Client promises to cooperate in the treatment of the Minor to the extent requested by Healing Together.
2. Psychotherapy sessions are scheduled to last 45 minutes, and take place at Healing Together’s office (the “Center”).
3. Healing Together does not, under any circumstances, provide transportation to or from the Center for the Client or the Minor.
Scope of Covered Services. (A) Except as otherwise provided for cases of Emergency Services, the Contractor is responsible to pay for all Covered Services listed in Attachment C. The Contractor shall also be responsible to pay for Covered Services that are, subsequent to the execution of this contract, deemed Covered Services due to amendments, revisions, or additions to the State Plan or to State or Federal regulations, guidelines or policies or made pursuant to court or administrative orders.
(B) The Contractor is responsible for payment of Emergency Services 24 hours a day, 7 days a week whether the services were provided by a Participating Provider or a Non-Participating Provider and whether the service was provided inside or outside of the Contractor’s Service Area.
Scope of Covered Services. A. In exchange for the fees set forth in the attached Rate Sheet (Appendix A), Attorneys agree to provide the services as defined under “The Full Retainer.” Services only partially covered or not covered at all will be charged at the defined "hourly rate."
B. Attorneys agree that the work performed by them on behalf of the will be performed in a workmanlike and competent manner and will be in compliance with all applicable ethical standards.
C. Attorneys agree to provide twenty-four (24) hour availability to the President or his/her designee through the use of electronic paging or other similar equipment. Attorneys shall make every attempt to return calls made by the ’s Executive Board Officers before the close of business the same day.
D. The agrees that it will be responsible for the fees of arbitrators, court reporters, consultants, expert witnesses, note takers, consulting attorneys and similar type fees, should any such fees be incurred, and for the cost of copying, postage and electronic research, and for Attorneys' travel, meals and lodging expenses. The also agrees that it will supply Attorneys with a list of those individuals with the authority to authorize work to be performed. It is expressly understood that only those individuals may authorize the provision of Attorneys’ services as enumerated herein.
E. In the event, attorney fees are awarded or agreed upon as a result of work performed during the term of this retainer by the Attorneys, such fees shall be divided equally between the Attorneys and the .