Children in Substitute Care Sample Clauses

Children in Substitute Care. Children who have been adjudicated dependent or delinquent and who are in the legal custody of a public agency and/or under the jurisdiction of the juvenile court and are living outside their homes, in any of the following settings: shelter homes, xxxxxx homes, group homes, supervised independent living, and Residential Treatment Facilities for Children (RTFs). Claim — A xxxx from a Provider of a medical service or product that is assigned a unique identifier (i.e. Claim reference number). A Claim does not include an Encounter form for which no payment is made or only a nominal payment is made. Clean Claim — A Claim that can be processed without obtaining additional information from the Provider of the service or from a third party. A Clean Claim includes a Claim with errors originating in the PH-MCO’s Claims system. Claims under investigation for Fraud or Abuse or under review to determine if they are Medically Necessary are not Clean Claims. Client Information System (CIS) — The Department's database of Recipients. The data base contains demographic and eligibility information for all Recipients. Community Provider — Private and public service organizations, that are not part of the PH-MCO’s Provider Network, with which the PH-MCO coordinates Out-of-Plan Services for their Members. Complaint — A dispute or objection regarding a participating Health Care Provider or the coverage, operations, or management policies of a Physical Health Managed Care Organization (PH-MCO), which has not been resolved by the PH-MCO and has been filed with the PH-MCO or with the Department of Health or the Pennsylvania Insurance Department of the Commonwealth, including but not limited to:  a denial because the requested service/item is not a covered benefit; or  a failure of the PH-MCO to meet the required time frames for providing a service/item; or  a failure of the PH-MCO to decide a Complaint or Grievance within the specified time frames; or  a denial of payment by the PH-MCO after a service has been delivered because the service/item was provided without authorization by a Provider not enrolled in the Pennsylvania Medical Assistance Program; or  a denial of payment by the PH-MCO after a service has been delivered because the service/item provided is not a covered service/item for the Member. The term does not include a Grievance. Concurrent Review — A review conducted by the PH-MCO during a course of treatment to determine whether the amount, duration and scope of t...
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Children in Substitute Care. Children who have been adjudicated dependent or delinquent and who are in the legal custody of a public agency and/or under the jurisdiction of the juvenile court and are living outside their homes, in any of the following settings: shelter homes, xxxxxx homes, group homes, supervised independent living, and Residential Treatment Facilities for Children (RTFs). CLAIM -- A xxxx from a provider of a medical service or product that is assigned a unique identifier (i.e. Claim reference number). A Claim does not include an encounter form for which no payment is made or only a nominal payment is made. CLEAN CLAIM -- A Claim that can be processed without obtaining additional information from the provider of the service or from a third party. A Clean Claim includes a Claim with errors originating in the Contractor's Claims system. Claims under investigation for fraud or abuse or under review to determine if they are Medically Necessary are not Clean Claims. CLIENT INFORMATION SYSTEM (CIS) -- The Department's database of MA Consumers. The data base contains demographic and eligibility information for all MA Consumers.
Sample 1
Children in Substitute Care. Children who have been adjudicated dependent or delinquent and who are in the legal custody of a public agency or under the jurisdiction of the juvenile court and are living outside their homes, in any of the following settings: shelter homes, xxxxxx homes, group homes, supervised independent living, and Residential Treatment Facilities (RTFs).‌
Sample 1
Children in Substitute Care. This aid category includes children in xxxxxx care born on or after May 1, 2000, who are currently enrolled in RIte Care on a voluntary basis or are in Medicaid fee-for-service (FFS). These children receive the same benefits as any other children (e.g., FIP and FIP-related).
Sample 1

Related to Children in Substitute Care

  • Admission of Substitute Limited Partner (a) Subject to the other provisions of this Article 9, an assignee of the Limited Partnership Interest of a Limited Partner (which shall be understood to include any purchaser, transferee, donee, or other recipient of any disposition of such Limited Partnership Interest) shall be deemed admitted as a Limited Partner of the Partnership only with the consent of the General Partner and upon the satisfactory completion of the following:

  • Portfolio Valuation and Diversification Etc Risk Factor Ratings;

  • Admission of Assignees as Substitute Limited Partners An Assignee will become a substitute Limited Partner only if and when each of the following conditions is satisfied:

  • Contractual Obligations and Similar Investments From time to time, the Fund's Investments may include Investments that are not ownership interests as may be represented by certificate (whether registered or bearer), by entry in a Securities Depository or by Book-Entry Agent, registrar or similar agent for recording ownership interests in the relevant Investment. If the Fund shall at any time acquire such Investments, including without limitation deposit obligations, loan participations, repurchase agreements and derivative arrangements, the Custodian shall (a) receive and retain, to the extent the same are provided to the Custodian, confirmations or other documents evidencing the arrangement; and (b) perform on the Fund's account in accordance with the terms of the applicable arrangement, but only to the extent directed to do so by Instruction. The Custodian shall have no responsibility for agreements running to the Fund as to which it is not a party other than to retain, to the extent the same are provided to the Custodian, documents or copies of documents evidencing the arrangement and, in accordance with Instruction, to include such arrangements in reports made to the Fund.

  • Preservation of Existence and Similar Matters Except as otherwise permitted under Section 9.4., the Borrower shall, and shall cause each other Loan Party and each other Subsidiary to, preserve and maintain its respective existence, rights, franchises, licenses and privileges in the jurisdiction of its incorporation or formation and qualify and remain qualified and authorized to do business in each jurisdiction in which the character of its properties or the nature of its business requires such qualification and authorization and where the failure to be so authorized and qualified could reasonably be expected to have a Material Adverse Effect.

  • Replacement of Lost Investments In the event of a loss of Investments for which the Custodian is responsible under the terms of this Agreement, the Custodian shall replace such Investment, or in the event that such replacement cannot be effected, the Custodian shall pay to the Fund the fair market value of such Investment based on the last available price as of the close of business in the relevant market on the date that a claim was first made to the Custodian with respect to such loss, or, if less, such other amount as shall be agreed by the parties as the date for settlement.

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