CASE MANAGEMENT PROGRAM Sample Clauses

CASE MANAGEMENT PROGRAM. The Case Management Program is a service for Members with complex medical needs or who may be at risk for future adverse health events due to an existing medical condition or who may require a wide variety of resources, information, and specialized assistance to help them manage their health and improve their quality of life. The program assigns an experienced case management nurse or coordinator to a Member or family caretaker to help make arrangements for needed care or to provide assistance in locating available community resources. Case management services provided to Members are numerous and are always tailored to the individual needs of a member. Participation in the Case Management Program is voluntary and involves no additional cost to our Members. Services often include, but are not limited to:  Assistance with coordination of care;  Discussion of disease processes;  Facilitating arrangements for complex surgical procedures, including organ and tissue transplants;  Facilitating arrangements for home services and supplies, such as durable medical equipment and home nursing care; or  Identification and referral to available community resources, programs; or organizations. Specialized Case Management Oncology Program This program is comprised of a dedicated oncology case management team of specially trained staff experienced in cancer care and end-of-life issues who provide assessment and support to members at all stages of adjustment to a cancer diagnosis. Core goals of this program include education regarding early symptom identification and pain management, increased member understanding of and satisfaction with their treatment plan, improved overall quality of life, and improved coping surrounding end-of-life issues. Care coordination benefits of the program include: management of care and services between the members, their family, providers, vendors, and the health plan; appropriate utilization of services; and the potential for cost savings through reductions in potentially avoidable admissions and emergency department use Transplant Case Management Program This program is comprised of a dedicated transplant case management team specially trained and experienced in transplant care that provides assessment, education, and support during the transplant process. Core goals of this program include education and support regarding treatments, medical benefit plan, and Blue Distinction® Centers for Transplants. Care Coordination benefits of the ...
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CASE MANAGEMENT PROGRAM. Aging and Adult Services will pay the contractor in consideration of Case Management Program services rendered through OAA funds, the rate of one- twelfth of the total reimbursement for this program per month, as long as this amount does not exceed the total cost of case management services rendered. AAS will pay the contractor a total of $3,000 for technology supplies, equipment and licenses for the Case Management Program. The maximum reimbursement for the Case Management Program during the contract term July 1, 2007 through June 30, 2008 shall not exceed THIRTEEN THOUSAND DOLLARS ($13,000).
Sample 1
CASE MANAGEMENT PROGRAM. Aging and Adult Services (AAS) will pay the Contractor in consideration of Case Management Program services rendered through OAA Title IIIB funds. The reimbursement amounts are calculated based on the following formula: Actual Expenditure minus (-) Total Revenue (Matching and Non-Matching Contributions and Project Income) equals (=) Total Reimbursement amount. If the Contractor prefers to have the reimbursement amount equally spread throughout the contract year, this can be achieved by utilizing the reimbursement formula indicated above, as long as the total reimbursement amount does not exceed the total cost of the services rendered. The maximum reimbursement for the Case Management Program during the contract term July 1, 2009 through June 30, 2010 shall not exceed TWENTY- FIVE THOUSAND DOLLARS ($25,000).
Sample 1
CASE MANAGEMENT PROGRAM. The TPA must develop and effectively implement a case management system in order to monitor high risk cases and provide assistance to the covered health care needs of the beneficiaries and dependents within the said category. The Case Management System must coordinate with services available and provided in the beneficiaries’ communities and homes as needed. Not limited to the physician’s office, mental health provider professionals office, or specialty center.
Sample 1
CASE MANAGEMENT PROGRAM. The Case Management Program is a service for Members with complex medical needs or who may be at risk for future adverse health events due to an existing medical condition or who may require a wide variety of resources, information, and specialized assistance to help them manage their health and improve their quality of life. The program assigns an experienced case management nurse or coordinator to a Member or family caretaker to help make arrangements for needed care or to provide assistance in locating available community resources. Case management services provided to Members are numerous and are always tailored to the individual needs of a member. Participation in the Case Management Program is voluntary and involves no additional cost to our Members. Services often include, but are not limited to:  Assistance with coordination of care;  Discussion of disease processes;  Facilitating arrangements for complex surgical procedures, including organ and tissue transplants;  Facilitating arrangements for home services and supplies, such as durable medical equipment and home nursing care; or  Identification and referral to available community resources, programs; or organizations.‌‌‌‌
Sample 1
CASE MANAGEMENT PROGRAM. A. Units of Service Contractor agrees to provide 430 hours of case management services.
Sample 1
CASE MANAGEMENT PROGRAM. The INSURER must develop and effectively implement a case management system in order to monitor high risk cases and provide assistance to the covered health care needs of the beneficiaries and dependents within the said category. The Case Management System must coordinate with services available and provided in the beneficiaries’ communities and their home as needed. Not limited to the physician’s office, mental health provider professionals office, or specialty center.
Sample 1
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CASE MANAGEMENT PROGRAM. A. Any other service approved by the Plan under case management program.
Sample 1
CASE MANAGEMENT PROGRAM. If you have injuries or an illness that may extend for some time, the Plan provides for services through case management. For example, if you are facing an extended period of care or treatment and these services may be accomplished in a skilled nursing facility or in your home, the case management program may be helpful in facilitating and coordinating this care. This can be beneficial to you because these settings may offer cost savings as well as other advantages to you and your family. When reviewing claims for the case management program, the case management provider always works with you, your family, and your physician so you receive close, personal attention. Through case management, the case management provider can consider recommendations involving expenses usually not covered for reimbursement. This includes suggestions to use alternative medical management techniques or procedures, or suggestions for cost-effective use of existing Plan provisions such as home health care and convalescent facilities. In order to be considered for payment under the Plan, the alternative care must result in savings without detracting from the quality of care. You, your provider, and the Plan must approve alternate care before it is provided in order to be covered by the Plan. Case management is voluntary. There is no penalty for not participating in case management or for leaving the case management program during its course. If you have questions regarding case management and its possible application to you, call the Administrative Office.
Sample 1

Related to CASE MANAGEMENT PROGRAM

  • Case Management Prompt resolution of any dispute is important to both parties; and the parties agree that the arbitration of any dispute shall be conducted expeditiously. The arbitrators are instructed and directed to assume case management initiative and control over the arbitration process (including scheduling of events, pre-hearing discovery and activities, and the conduct of the hearing), in order to complete the arbitration as expeditiously as is reasonably practical for obtaining a just resolution of the dispute.

  • Disease Management If you have a chronic condition such as asthma, coronary heart disease, diabetes, congestive heart failure, and/or chronic obstructive pulmonary disease, we’re here to help. Our tools and information can help you manage your condition and improve your health. You may also be eligible to receive help through our care coordination program. This voluntary program is available at no additional cost you. To learn more about disease management, please call (000) 000-0000 or 0-000-000-0000. About This Agreement Our entire contract with you consists of this agreement and our contract with your employer. Your ID card will identify you as a member when you receive the healthcare services covered under this agreement. By presenting your ID card to receive covered healthcare services, you are agreeing to abide by the rules and obligations of this agreement. Your eligibility for benefits is determined under the provisions of this agreement. Your right to appeal and take action is described in Appeals in Section 5. This agreement describes the benefits, exclusions, conditions and limitations provided under your plan. It shall be construed under and shall be governed by the applicable laws and regulations of the State of Rhode Island and federal law as amended from time to time. It replaces any agreement previously issued to you. If this agreement changes, an amendment or new agreement will be provided.

  • PERFORMANCE MANAGEMENT SYSTEM 5.1 The Employee agrees to participate in the performance management system that the Employer adopts or introduces for the Employer, management and municipal staff of the Employer.

  • Program Management 1.1.01 Implement and operate an Immunization Program as a Responsible Entity

  • Programme Management The Government will establish a programme management office and the Council will be able to access funding support to participate in the reform process. The Government will provide further guidance on the approach to programme support, central and regional support functions and activities and criteria for determining eligibility for funding support. This guidance will also include the specifics of any information required to progress the reform that may be related to asset quality, asset value, costs, and funding arrangements.

  • Project Management Plan 1 3.4.1 Developer is responsible for all quality assurance and quality control 2 activities necessary to manage the Work, including the Utility Adjustment Work.

  • Construction Management Plan Contractor shall prepare and furnish to the Owner a thorough and complete plan for the management of the Project from issuance of the Proceed Order through the issuance of the Design Professional's Certificate of Material Completion. Such plan shall include, without limitation, an estimate of the manpower requirements for each trade and the anticipated availability of such manpower, a schedule prepared using the critical path method that will amplify and support the schedule required in Article 2.1.5 below, and the Submittal Schedule as required in Article 2.2.3. The Contractor shall include in his plan the names and resumés of the Project Superintendent, Project Manager and the person in charge of Safety.

  • Management Plan The Management Plan is the description and definition of the phasing, sequencing and timing of the major Individual Project activities for design, construction procurement, construction and occupancy as described in the IPPA.

  • Adaptive Management ‌ This CCAA is based on the principles of Adaptive Management set out in 65 Fed. Reg. at 35,242. The adaptive management process is a structured approach for dealing with uncertainty. The adaptive management process develops hypotheses regarding uncertainty and research to test those hypotheses in an iterative process to develop effective strategies for minimizing the uncertainty. The signatories to this CCAA agree and recognize that implementation of the Conservation Strategy objectives and criteria, Conservation Measures and Actions, and the Covered Area may change as new science emerges. The effectiveness of the Conservation Strategy objectives and criteria, Conservation Measures, Conservation Actions, monitoring methods, and new technologies will be reviewed by the Administrator on an annual basis, with input from the Adaptive Management Committee. The Adaptive Management Committee will be responsible for reviewing and evaluating the effectiveness of Conservation Program under the 2020 DSL CCAA as described in Sections 2.0 and 16.1, including the effectiveness and implementation of the Conservation Strategy, Conservation Measures and Conservation Actions; setting priorities for DSL Habitat conservation and monitoring habitat loss; and recommending changes to any aspect of the Conservation Program based on new science. As a result, appropriate modifications to the Conservation Measures and Actions may be incorporated to further refine the goals and objectives of this 2020 DSL CCAA. Such modifications are incorporated into existing CIs, if they were identified in changed circumstances in the 2020 DSL CCAA. Modifications not related to changed circumstances identified in the 2020 DSL CCAA and instead related to unforeseen circumstances may be incorporated into new CIs that take effect after the modifications have been made and to existing CIs only with written consent from the Participants and Service. Additionally, research projects that are designed to determine the effectiveness of management practices will be encouraged and utilized to determine what Adaptive Management is necessary. Changes resulting from Adaptive Management will flow through the Governance structure as described in Section 2.0 of this CCAA.

  • Performance Management 17.1 The Contractor will appoint a suitable Account Manager to liaise with the Authority’s Strategic Contract Manager. Any/all changes to the terms and conditions of the Agreement will be agreed in writing between the Authority’s Strategic Contract Manager and the Contractor’s appointed representative.

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