Coverage Determination Sample Clauses

Coverage Determination. An ICDS Plan decision to approve or deny a request for a covered service, also referred to as Prior Authorization decision.
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Coverage Determination. Coverage shall be placed on the basis of proven certification and experience on January 1 st each year, or where the employee is not on staff at January 1st, on the date that the employee commences employment.
Sample 1
Coverage Determination. Coverage shall be placed on the basis of proven certification and experience on January 1st each year, or where the employee is not on staff at January on the date the employee commences employment. The maximum amount of insurance on an employee shall be six hundred percent (600%) of the Category minimum of the teachers' salary scale. Annual in
Sample 1

Related to Coverage Determination

  • Adverse Benefit Determination An adverse benefit determination is any of the following:  Denial of a benefit (in whole or part),  Reduction of a benefit,  Termination of a benefit,  Failure to provide or make a payment (in whole or in part) for a benefit, and  Rescission of coverage, even if there is no adverse effect on any benefit. An appeal of an adverse benefit determination can be made either as an administrative appeal or as a medical appeal, as defined further in this section. Our Customer Service Department phone number is (000) 000-0000 or 0-000-000-0000.

  • Interest determination (a) Where Screen Rate Determination is specified in the applicable Final Terms as the manner in which the Rate of Interest is to be determined, the Rate of Interest for each Interest Period will, subject as provided below, be either:

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