Agency for Health Care Administration Sample Clauses

Agency for Health Care Administration the lead agency for Title XXI of the Act for purposes of receipt of federal funds, reporting, and for ensuring compliance with federal and State regulations and rules. Appeal: a review by Insurer of an Adverse Benefit Determination.
Sample 1
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Agency for Health Care Administration. Conducted a Medicaid Information Technology Architecture Assessment and an in-depth analysis of infrastructure and business and technical capabilities, including developing goals and objectives, addressing system impacts, and identifying the desired state of business processes.  Agency for Health Care Administration: Provided project management, research, planning, and procurement support services to assist in procuring a new fiscal agent and enhancements to the development of the Medicaid Management Information System and Decision Support System. Arizona  Management strategy  Project management  Program research, planning, & evaluation  Studies, analyses, scenarios, and reports  Policy and regulation development  Process and productivity improvement
Sample 1
Agency for Health Care Administration. Ancillary Services - Services provided at a hospital include, but are not limited to, radiology, pathology, neurology, and anesthesiology as specified in the Hospital Coverage and Limitations Handbook. Area Agency on Aging - An agency designated by the Department to develop and administer a plan for a comprehensive and coordinated system of services for older persons. Assessment - An individualized comprehensive appraisal of an individual’s medical, developmental, mental, social, financial, and environmental status conducted by a qualified individual for the purpose of determining the need for long term care services. Capitation Rate - The monthly fee paid by the Agency to the contractor for each enrollee enrolled under the contract for the provision of services during the payment period. Care Plan - A plan which describes the service needs of each recipient, showing the projected duration, desired frequency, type of provider furnishing each service, and scope of the services to be provided. CARES (Comprehensive Assessment and Review for Long Term Care Services) - A nursing facility pre- admission screening program operated by the Agency through an interagency agreement with the Department of Elder Affairs. The program explores all available options to nursing home placement to ensure that long-term care services are provided in the setting most appropriate to the needs of the person and consistent with approved federal waiver programs. Claim - A claim is: (1) a xxxx for services, (2) a line item of service or, (3) all services for one enrollee within a xxxx. Clean Claim - A claim that can be processed without obtaining additional information from the provider (subcontractor) of the service or from a third party. Cold-call Marketing - Any unsolicited personal contact by the contractor or subcontractors with a potential enrollee for the purpose of marketing. Contractor - The organizational entity with whom this agreement is executed. Department: Department of Elder Affairs Disenrollment - The discontinuance of an enrollee's membership in the contractor’s plan. Durable Medical Equipment - Medical equipment that can withstand repeated use; is primarily and customarily used to serve a medical purpose; is generally not useful in the absence of illness or injury; and is appropriate for use in the recipient's home. Emergency Medical Condition - According to 42 CFR 438.114(a), a medical condition manifesting itself by acute symptoms of sufficient severity (includi...
Sample 1
Agency for Health Care Administration. 1. Provide TA to the Department.
Sample 1
Agency for Health Care Administration. Ancillary Services - Services provided at a hospital include, but are not limited to, radiology, pathology, neurology, and anesthesiology as specified in the Hospital Coverage and Limitations Handbook. Appeal - A formal request from an enrollee to seek a review of an action taken by the Contractor pursuant to 42 CFR 438.400(b).
Sample 1

Related to Agency for Health Care Administration

  • Program Administration An activity relating to the general management, oversight and coordination of community development programs. Costs directly related to carrying out eligible activities are not included.

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  • Health Promotion and Health Education Both parties to this Agreement recognize the value and importance of health promotion and health education programs. Such programs can assist employees and their dependents to maintain and enhance their health, and to make appropriate use of the health care system. To work toward these goals:

  • Policy Administration The Company shall provide all required, necessary and appropriate claims, administrative and other services with respect to the Policies. The Company shall use reasonable care in its administration and claims practices with respect to the Policies and in administering and performing its duties under this Agreement and such practices, administration and performance shall (a) conform with Applicable Law; (b) not be fraudulent; and (c) be no less favorable than those used by the Company with respect to other policies of the Company not reinsured by the Reinsurer.

  • Agreement Administration SBBC has delegated authority to the Superintendent of Schools or his/her designee to take any actions necessary to implement and administer this Agreement.

  • PAY ADMINISTRATION 7.1.1 Promotion occurs when the incumbent of a regular position is assigned to another position in a class with a higher maximum salary than the class of his or her former position.

  • Reinsurance Administration THE COMPANY shall perform all duties with respect to the administration of the reinsurance under this Agreement on the portion of the policies reinsured under this Agreement.

  • Grant Administration The District recognizes that Charter Schools are utilizing revenue sources associated with federal and state agency grants. The District is required to be Fiscal Agent on such grants meaning the District is responsible for oversight, approval, review and distribution of funds. These administrative tasks result in the utilization of District resources. In recognition of this, the District is mandating the following.

  • REGULATORY ADMINISTRATION SERVICES BNY Mellon shall provide the following regulatory administration services for each Fund and Series:  Assist the Fund in responding to SEC examination requests by providing requested documents in the possession of BNY Mellon that are on the SEC examination request list and by making employees responsible for providing services available to regulatory authorities having jurisdiction over the performance of such services as may be required or reasonably requested by such regulatory authorities;  Assist with and/or coordinate such other filings, notices and regulatory matters and other due diligence requests or requests for proposal on such terms and conditions as BNY Mellon and the applicable Fund on behalf of itself and its Series may mutually agree upon in writing from time to time; and

  • Administration and Servicing OF MORTGAGE LOANS

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