TESTING SERVICES DESCRIPTION This Exhibit contains additional terms and conditions applicable to testing services for digestive disorders (the “Testing Services”) that you may have purchased. The additional terms and conditions in this Exhibit only apply to the services described in this Exhibit.
Level of Service Complex case management with a provider focus is appropriate for members who either choose not to be actively involved or are unable to actively participate in their health care. Complex case management targets members with two (2) or more disease states who need assistance with care coordination, making preventive care appointments, or accessing care to address the members’ chronic health conditions or members who have had an inpatient hospital stay in the last ninety (90) days or members with high dollar claims of over fifty thousand dollars (>$50,000) in six (6) months. The focus is on working with the providers to meet the needs of the individual through communication with the PMP (if applicable), other providers, and the member’s natural support system. The goal is to help members gain optimum health or improved functional capability, in the right setting and in a cost-effective manner. Complex case management with provider focus is the active coordination by the Contractor of care and services between providers while navigating the extensive systems and resources required for the member. It involves comprehensive assessment, determination of available benefits, development and implementation of a complex case management plan directed at the chronic health conditions. At a minimum, the Contractor must provide complex case management services for members discharged from an inpatient psychiatric, drug overdose, or substance abuse hospitalization, for no fewer than ninety (90) calendar days following that inpatient hospitalization discharge. The Contractor must also provide complex case management services for any member at risk for inpatient psychiatric or substance abuse re -hospitalization. Care managers must contact members during an inpatient hospitalization or as soon as practicable upon receiving notification of a member’s inpatient behavioral health hospitalization. The care manager must work with the hospital discharge planner, provider case manager and/or natural supports (i.e. family) to ensure that an outpatient follow-up appointment is scheduled to occur no later than seven (7) calendar days following the inpatient behavioral health hospitalization discharge and transportation is not a barrier to attending the appointment. Complex case management with provider focus includes all of the services and benefits from disease management and care management. In addition,
Hosting Services NCR Voyix shall furnish facilities, equipment, computer programs and services, as specified from time to time by NCR Voyix, that NCR Voyix deems necessary for operation and maintenance of the System (collectively, the “Hosting Services”).
Warranty Service 1. When repair or replacement services covered by this Agreement are required, you must telephone us at the toll-free service number printed on your Agreement Coverage Summary page. Telephone service is available twenty-four (24) hours a day, seven (7) days a week. You must notify us immediately upon discovery of any mechanical failure, and prior to the expiration of the term of the Agreement during which the failure occurred. If you fail to notify us of any mechanical failure prior to the expiration of the term of the Agreement during which the failure occurred, we will not be responsible for the cost of any repairs and/or replacements resulting from the mechanical failure. 2. We will provide you with a referral to an independent service contractor. We will use reasonable efforts to provide a referral to an independent service contractor within two (2) hours after the service request is received during normal business hours and within twenty-four (24) hours for requests received after normal business hours and on weekends or holidays. In the event we determine, at our sole discretion, that there is an emergency situation requiring expedited service, we will make reasonable efforts to expedite service. We will determine, at our sole discretion, which repairs constitute an emergency and will give consideration to covered mechanical failures that affect the habitability of the dwelling. 3. We have sole authority to select independent service contractors. All repair and/or replacement work covered by this Agreement must be performed by a pre-approved independent service contractor, and all repair and replacement services must be approved by us in advance. We are not responsible or liable for and will not cover any expenses you incur without our prior express consent, and we will not reimburse you for any costs you incur associated with unauthorized repair or replacement work performed by unauthorized contractors. 4. This Agreement includes a deductible charge, listed on your Agreement Coverage Summary, that you must pay per trade on each service call made towards the covered portion of any claim. When a covered claim requires more than one trade to complete the covered repair/replacement only one deductible charge will be required. Trades include appliance, air conditioning, heating, electrical, plumbing, and any other trade specifically required to service Covered Items listed on your Agreement Coverage Summary. You are responsible for and shall pay the independent service contractor directly for the service call and for actual work performed and/or Items installed, up to the amount of the deductible at the time of visit(s), in a manner acceptable to the independent service contractor. You are responsible for and shall pay the independent service contractor for any amounts due for services performed or parts installed that are not covered under the terms, conditions and provisions of this Agreement. A service call includes, without limitation, inspecting, diagnosing, and/or performing service for the repair or replacement of a malfunctioning Item. 5. You will provide access to the covered property during normal business hours for the independent service contractor to diagnose, obtain approval for, and/or complete repairs for covered mechanical failures. You will pay us and/or our independent service contractor for any service charges and additional charges assessed by our independent service contractor resulting from your failure to provide access to the covered property and/or for missed appointments. 6. Should any building or zoning permits be necessary, you are responsible for paying for and/or obtaining these permits and the cost associated with these permits. 7. At our discretion, we may elect to replace a Covered Item rather than repair it. The decision to replace rather than repair Covered Items is solely our option. Should we choose to replace a Covered Item the replacement will be the base model that meets all applicable federally mandated minimal manufacturers’ standards, performs the same primary function, and has a capacity comparable to the Covered Item, when available with domestically assembled units. With respect to kitchen/laundry appliances, we will make reasonable efforts to provide replacement Covered Items having similar mechanical capabilities and/or efficiency of the original unit, when available. We are not required to provide exact match in color, dye, lot, material, type or brand. When replacing systems or appliances, we will be responsible for the installation of the replacement Covered Item but not for the cost of the construction, modifications, carpentry or transitional work made necessary in order to accommodate the replacement, nor for any costs to upgrade or modify Covered Items for any reason. Should we determine to replace Covered Item and you instead choose to effect a repair, that Covered Item shall be excluded from further coverage under this Agreement and subsequent renewals. 8. At our discretion, we may give you the option to elect to receive a repair/replacement credit or cash payment (net of deductible) in lieu of providing a repair. In such cases, the amount of such credit shall be equal to the lesser of the approved cost of repair or the estimated cost of replacement. If you elect a credit to our independent service contractor, we will pay that amount directly to the independent service contractor after the work has been completed. If you elect the cash payment, you must supply documentation supporting that the Item in question has been purchased, replaced or repaired prior to receiving the cash payment. Any replacement Item must be installed in the covered property as listed on the Agreement Summary Page. The amount of the approved cost of repair or replacement will be established by us at our sole discretion. We reserve the right to inspect repaired and/or replacement Items. 9. We reserve the right to obtain, at our expense, a second opinion by an independent service contractor prior to determining eligibility for coverage.
Performance Testing (a) All performance tests of the Project, including any Initial Performance Test required in Section 2 of Appendix VIII, will be performed in accordance with the test procedures set forth in Appendix VIII (“Performance Test”), including additional procedures and protocols related to Performance Testing as mutually agreed between Buyer and Seller (“Test Procedures”). Seller shall bear all costs and receive all revenues, if applicable, associated with all Performance Tests. (b) After the Initial Delivery Date and during the Delivery Term, Buyer will have the right to conduct a Performance Test (“Buyer Performance Test”) no more than once a calendar year to demonstrate whether the Project is capable of delivering the Distribution Services at the Contract Capacity. Within 30 calendar days following a Buyer Performance Test, Seller will have the right to retest the Project with a Performance Test (“Seller Retest”). For the avoidance of doubt, the results of any Seller Retest will supersede the results of the preceding Buyer Performance Test. (i) If a Buyer Performance Test or, if a corresponding Seller Retest has occurred, a Seller Retest demonstrates the Project is capable of delivering Distribution Services at or above ninety-nine percent (99%) of the Initial Contract Capacity, the Contract Capacity will remain the Initial Contract Capacity; (ii) If a Buyer Performance Test or, if a corresponding Seller Retest has occurred, a Seller Retest demonstrates the Project is capable of delivering Distribution Services at more than or equal to eighty-five (85%) of the Initial Contract Capacity, but less than ninety-nine percent (99%) of the Initial Contract Capacity (“Testing Band”), the Contract Capacity will be automatically adjusted (upwards or downwards) to the capacity commensurate with the amount of Distribution Services the Project delivered during the Performance Test within the Testing Band. (iii) If a Buyer Performance Test or, if a corresponding Seller Retest has occurred, a Seller Retest demonstrates the Project is not capable of delivering Distribution Services of at least eighty-five percent (85%) of the Initial Contract Capacity, an Event of Default shall occur in accordance with Section 7.1(a)(viii).