Copayment and Residents of Nursing Facility Sample Clauses

Copayment and Residents of Nursing Facility. For MSC+ Enrollees, upon notification to the MCO that a Medical Assistance Enrollee has been a resident of a Nursing Facility for thirty (30) days or more, the MCO shall ensure that its Providers do not require the Enrollee to pay any copayments, and shall reimburse its Providers any copayment amount paid. The MCO may submit an invoice and a data certification to the STATE for all copayments the MCO has reimbursed to its Providers in the previous quarter, no more often than quarterly. The STATE shall verify the Medical Assistance Enrollee’s living arrangement, and date of service on the encounter claim, prior to payment to the MCO for the amounts the MCO claims to have reimbursed to its Providers.
Sample 1Sample 2Sample 3
AutoNDA by SimpleDocs

Related to Copayment and Residents of Nursing Facility

  • Skilled Nursing Facilities a. The following Health Care Services may be Covered Services when you are a patient in a Skilled Nursing Facility: i. room and board;

  • Hospitals of Ontario Voluntary Life Insurance Plan The Hospital also agrees to make the Hospitals of Ontario Voluntary Life Insurance Plan (HOOVLIP) available to the nurses subject to the provisions of HOOVLIP at no cost to the Hospital.

  • Office Visit Copayments In each year of the Agreement, the level of the office visit copayment applicable to an employee and dependents is based upon whether the employee has completed the on-line Health Assessment during open enrollment and has agreed to opt-in for health coaching.

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services.

  • Skilled Care in a Nursing Facility This plan covers skilled nursing services in a skilled nursing facility if: • the services are prescribed by a physician: • your condition needs skilled nursing services, skilled rehabilitation services or skilled nursing observation; • the services are provided by or supervised by licensed technical or professional medical personnel; and • the services are not custodial care, respite care, day care, or for the purpose of assisting with activities of daily living.

  • General Education Requirements for Azusa Pacific University Requirement Helpful Hints & Comments First-Year Seminar Course must focus on orientation to college academics while maintaining instruction in orientation, transitions, and holistic wellness. Typically, a 3-unit course. Not required for students who transfer in 30+ units. Writing 1: The Art & Craft of Writing Any first-semester composition course. Often titled "Freshman Composition," "College Composition," or "Reading and Composition." Must include basic research skills and a research paper. Writing 2: Genre, Evidence, & Persuasion Courses titled "Critical Thinking," "Advanced Composition," etc., that follow a basic freshman level writing course. These courses involve the use of logic, critical thinking, rhetoric, and advanced composition. In addition, genre-specific writing courses will introduce students to the genres of writing, rhetorical moves, and forms of evidence in a specific discipline. Possible courses include: Writing in the Humanities, Writing in the Social Sciences, Writing in the Arts, Writing in Theology, Writing in Business, Writing in Nursing, etc. Must include a research component. Writing 3: Writing in the Disciplines This category focuses on preparing students to be professionals in a field by being independent thinkers capable of constructing their own knowledge, including producing polished writing products in the genres of writing that students are likely to use in their future professions. Most courses in this category are required for the specific APU major and are therefore not likely to be fulfilled by a student's transfer work. Oral Communication Any Public Speaking or Oral Communication course. Must contain at least 3 individual public speeches. Also, communication courses in Interpersonal, Small Group, Argumentation and Debate, and Intercultural areas are acceptable (however, some majors may require Public Speaking). Cannot be taken as a hybrid course. Personal Wellness Any physical activity course with a cardio component and instruction in fitness principles. This includes individual activities, team sports, dance, yoga/mat exercise courses, and intercollegiate sports. Activities with limited physical activity such as badminton, golf, bowling, etc. will not fulfill the requirement. Quantitative Literacy Any course from the Math department of the transferring school that has a prerequisite of Intermediate Algebra. However, certain majors require College Algebra. Please refer to the APU catalog to determine whether or not your major requires College Algebra. In addition, Statistics and Applied Statistics courses (e.g. "Statistics for Behavioral Sciences") with an Intermediate Algebra prerequisite will meet this requirement. Biblical, Theological, & Philosophical Formation- Philosophy Requirement Must be a broad philosophy course such as Intro to Philosophy, History of Philosophy, philosophy-based Logic, Critical Thinking, and Ethics. All other courses must be evaluated by the Department of Theology & Philosophy for transfer. Humanities- History, Literature, & Fine Arts Requirement Must choose one course from each discipline (3 courses total): History, Literature, and Fine Arts. History courses must be survey courses in world, western, or U.S. history (typically split into two time periods). Literature courses must be broad, surveys of literature that explore the literary genres of fiction, drama, and poetry. Fine Arts courses must be broad, survey courses in Art, Music, Drama, or Theater (sometimes History of Cinema, Drama, or Theater courses) covering approximately 100 years. These must be lecture courses and not studio or applied courses such as drawing, painting, singing, piano, etc. Examples of acceptable courses from these categories include (but not limited to) World Civilizations to 1648, Intro to Literature, Art History, Music Fundamentals, etc. Social Sciences One course from the following disciplines: Sociology, Psychology, Economics, Anthropology, Communication Studies, or Political Science. Examples of courses include (but not limited to) Intro to Sociology, General Psychology, Intro to Criminal Justice, Cultural Anthropology, Mass Media, etc. Natural Sciences One course: lecture and lab component required. Any basic course in the life or physical sciences. Examples of courses include Fundamentals of Biology, General Biology, Fundamentals of Chemistry, General Chemistry, Introduction to Astronomy, Physical Geology/Geography, Fundamentals of Physics, General Physics, Oceanography, Zoology, Marine Biology. Biology and Chemistry labs cannot be taken online. However, certain majors require specific science courses. Please refer to the APU catalog to determine whether or not your major requires specific science courses.

  • LIMITATIONS OF COVERED MEDICAL SERVICES In order to be covered, the Member’s Attending Physician must specifically prescribe such services and such services must be consequent to treatment of the cleft lip or cleft palate.

  • Outpatient emergency and urgicenter services within the service area The emergency room copay applies to all outpatient emergency visits that do not result in hospital admission within twenty-four (24) hours. The urgicenter copay is the same as the primary care clinic office visit copay.

  • The Nursing Homes and Related Industries Pension Plan In this Article, the terms used shall have the meanings as described:

  • Health Care Spending Account After six (6) months of permanent employment, full time and part time (20/40 or greater) employees may elect to participate in a Health Care Spending Account (HCSA) Program designed to qualify for tax savings under Section 125 of the Internal Revenue Code, but such savings are not guaranteed. The HCSA Program allows employees to set aside a predetermined amount of money from their pay, not to exceed the maximum amount authorized by federal law, per calendar year, of before tax dollars, for health care expenses not reimbursed by any other health benefit plans. HCSA dollars may be expended on any eligible medical expenses allowed by Internal Revenue Code Section 125. Any unused balance is forfeited and cannot be recovered by the employee.

Time is Money Join Law Insider Premium to draft better contracts faster.