Dependent Eligibility Verification Services Sample Clauses
Dependent Eligibility Verification Services. In accordance with Section 3.5.23 (C) Dependent Eligibility Verification Services, the Service Provider shall work cooperatively with the Department to assist with the third-party eligibility verification services in Fiscal Year 2017-18. Specifically, the Service Provider agrees to manually dis-enroll any dependent that is deemed ineligible, process Level I appeals, and answer calls from Participants regarding dis-enrollments and Level 1 appeals. The Department agrees to pay the Service Provider $94,491 in Fiscal Year 2017-18 for the above services. This payment will be divided into 12 equal monthly payments and added to the already agreed upon monthly invoice payment beginning on July 1, 2017.
Dependent Eligibility Verification Services. Eligibility determination services are hereby added to #21 of Section I.B., Benefits Processes Listing, of the “People First Service Center As Is Requirements - Updated Oct. 2, 2015” document (incorporated into the Contract in the definition of “Supplemental Service Center Description” and required to be provided by Section 3.4.2 of the Contract), which is replaced in its entirety with the following: 21 Document Processing All forms and correspondence mailed or submitted through the online portal to the PFSC are entered into the Case Management Tool. Agents can view this information by looking under the corresponding system- generated case. Forms and correspondence provided to the PFSC are used by the PFSC to validate the eligibility of all dependents that are added to the Covered Population. This includes conducting verification of eligibility, updating dependents as eligible or ineligible, removing ineligible dependents, reinstating eligible dependents based on appeals, and handling other related administrative actions. For purposes of validation of eligibility, the separate processes as defined in numbers 9, 16, 18, 19 and 20 shall be processed as Tier 2 stated in those items. For all others this verification process shall not prohibit the dependent from being added to coverage prior to completion of the verification process.