Authorization of Services definition

Authorization of Services. For the processing of requests for initial and continuing authorizations of services, the Contractor shall have in place, and follow, written policies and procedures. The Contractor shall have mechanisms in place to ensure consistent application of review criteria for authorization decisions. Any decision to deny a service authorization request or to authorize a service in an amount, duration, or scope that is less than requested, shall be made by a health care professional who has appropriate clinical expertise in treating the member's condition or disease.
Sample 1

Examples of Authorization of Services in a sentence

  • The notice shall meet the requirements of 42 CFR 438.404, “Notice of Action.” See Section 6.3.2, Authorization of Services and Notices of Action for additional information.

  • Refer to the Authorization of Services and Supplies section of this Benefit Plan and the Schedule of Benefits for additional information.

  • Offeror has failed to make progress in the performance of the requirements of the Contract or Authorization of Services, or Offeror fails to give PMGAA adequate assurance the Offeror will perform the Contract in full and on time.

  • Offeror has failed to furnish the required service(s) and/or product(s) within the time stipulated in the Contract or associated Authorization of Services.

  • Authorization of Services: The Contractor shall have in place and follow written policies and procedures for the processing of requests for initial and continuing authorizations of services.

  • All Admissions (including, but not limited to, elective or non-emergency, Emergency, Pregnancy Care, Mental Disorders and alcohol and/or drug abuse Admissions) must be Authorized as outlined in Authorization of Services.

  • Consultant has failed to furnish the required service(s) and/or product(s) within the time stipulated in the Contract or associated Authorization of Services.

  • Authorization of Services: The processing of requests for initial and continuing service delivery.

  • Consultant has failed to make progress in the performance of the requirements of the Contract or Authorization of Services, or Consultant fails to give PMGAA adequate assurance the Consultant will perform the Contract in full and on time.

  • The Managed Care Plan may provide any of the following in lieu of services to enrollees when determined medically appropriate, in accordance with the requirements specified in Attachment II, Section VI., Coverage and Authorization of Services, after obtaining approval from the Agency: Structured Family Caregiving - A service for plan members residing in nursing facilities who can be transitioned safely in a community setting but for whom more intensive in-home assistance/support is needed.

Related to Authorization of Services

  • Termination of Services means Participant’s Termination of Consultancy, Termination of Directorship or Termination of Employment, as applicable.

  • Scope of Services or “Scope of Work” means the work to be performed by the Proposer or Consultant as described in Section 2.0 of this RFP, as amended thereto.

  • regular services means services which provide for the carriage of passengers at specified intervals along specified routes, passengers being picked up and set down at predetermined stopping points;

  • Level of service has the meaning set forth in Section 2.02(c).

  • Cost of Services is FASC’s total Operating Costs incurred in providing the applicable Category of Services during the month to all investment advisers for which FASC provides that Category of Services. “Adviser’s Assets under Management” is the total average assets under management for the month for all Accounts or portions thereof for which the Adviser acts as investment adviser or subadvisor and which utilize the Category of Services.

  • Administrative Services means the provision to the Fund, by or at the expense of the Manager, of the following:

  • Preventive services means preservation services, as defined

  • Denial of Service Attack means an attack intended by the perpetrator to overwhelm the capacity of a "computer system" by sending an excessive volume of electronic data to such "computer system" in order to prevent authorized access to such "computer system".

  • Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be:

  • Basic generation service or "BGS" means electric generation