Verify Member Eligibility Sample Clauses

Verify Member Eligibility. Prior to furnishing any Covered Prescription Service, PHARMACY shall verify that the individual receiving such Covered Prescription Service is an eligible Member. Such verification shall be performed by the PHARMACY through point-of-service (“POS”) data communication between the PHARMACY and Claims Processor. If any PHARMACY is unable to confirm a Member’s eligibility by POS communication, then the PHARMACY shall call SOUTHERN SCRIPTS’ pharmacy help desk (or equivalent) for verification.
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Verify Member Eligibility. 3. Determine the Medical Necessity of medical transportation services in accordance with the Medical Necessity standards set forth in the applicable Administrative Manual. Any claim that would be denied on the basis of Medical Necessity shall be referred to the Contracted Health Plan prior to denial. Except as otherwise provided in the applicable Administrative Manual, (a) the Contracted Health Plan, or its designee, shall be solely responsible for notifying the Member of the denial of any claim; and (b) CONTRACTOR shall not contact the Member with respect to any denial of claims. If the Contracted Health Plan approves the claim, it shall notify CONTRACTOR of the approval, and CONTRACTOR shall promptly pay the claim. Notwithstanding the foregoing, if Customer's referral authorization is included in the claims submission, then the Medical Necessity of the claims will be deemed to be determined, and further review will not be required.
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Related to Verify Member Eligibility

  • Distribution Eligibility Shares issued in a Fund after receipt of a completed purchase order shall be eligible to receive distributions of the Fund at the time specified in the prospectus pursuant to which the Shares are offered.

  • Bonus Eligibility The Executive shall be eligible to receive an annual bonus payment in addition to Base Salary and other compensation for each year of the Executive’s employment (the “Bonus”) as determined by the Board from time to time.

  • S-3 Eligibility (i) At the time of filing the Registration Statement and (ii) at the time of the most recent amendment thereto for the purposes of complying with Section 10(a)(3) of the Securities Act (whether such amendment was by post-effective amendment, incorporated report filed pursuant to Section 13 or 15(d) of the Exchange Act or form of prospectus), the Company met the then applicable requirements for use of Form S-3 under the Securities Act, including compliance with General Instruction I.B.1 of Form S-3.

  • DTC Eligibility The Company, through the Transfer Agent, currently participates in the DTC Fast Automated Securities Transfer (FAST) Program and the Common Stock can be transferred electronically to third parties via the DTC Fast Automated Securities Transfer (FAST) Program.

  • Eligibility It will notify the Issuer and the Servicer promptly if it no longer meets the eligibility requirements in Section 5.1.

  • Rule 144A Eligibility On the Closing Date, the Securities will not be of the same class as securities listed on a national securities exchange registered under Section 6 of the Exchange Act or quoted in an automated inter-dealer quotation system; and each of the Preliminary Offering Memorandum and the Offering Memorandum, as of its respective date, contains or will contain all the information that, if requested by a prospective purchaser of the Securities, would be required to be provided to such prospective purchaser pursuant to Rule 144A(d)(4) under the Securities Act.

  • Form S-3 Eligibility The Company is eligible to register the resale of the Securities for resale by the Purchaser on Form S-3 promulgated under the Securities Act.

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