Disease Management Services Sample Clauses

Disease Management Services. For the service fee specified in Exhibit A, We will provide disease management services independently or through a third party contracted entity or affiliate. These services are designed to proactively (i) identify and stratify Participants diagnosed with specific chronic medical conditions or who may be at risk for developing chronic medical conditions, (ii) provide assessment and intervention to support such Participants, as well as the Participants' physicians, and (iii) help such Participants comply with a physician's established plan of care as well as monitoring and educating Participants regarding the medical condition. The services are designed to provide intervention with respect to Participants' specific chronic medical conditions that are highly likely to drive medical expenses of the Plan. Participant and physician participation will be voluntary. These services include the congestive heart failure, coronary artery disease, diabetes, and asthma programs. You agree to provide Us (or cause Your vendor to provide Us), in a timely manner with all information that We reasonably require to provide Your Participants with disease management services in accordance with this Section and Our program guidelines. We shall be entitled to rely on the information that is provided to Us in connection with Our provision of disease management services to Your Participants. We can terminate the disease management services in whole or in part at any time for any reason if such termination applies to all of Our similarly situated self-funded customers. After the initial twelve (12) months of disease management services under this Agreement, You may terminate the disease management services upon thirty (30) days prior written notice to Us. In the unlikely event You terminate within the first twelve (12) months after the effective date of these disease management services, You will be responsible for the disease management services fees reflected in Exhibit A for the full twelve (12) month period. We will provide reasonable transition services to Participants enrolled in a disease management program at the time of termination for a period not to exceed one hundred twenty (120) days following either party's notice of termination to the other, unless otherwise agreed to by the parties; provided however, We shall have no obligation to provide such transition services if termination is a result of Your material breach, Your failure to pay Us fees due, or Your failure to p...
Sample 1
AutoNDA by SimpleDocs
Disease Management Services. Contractor is responsible for initiating and maintaining disease management services for Members who are at risk of adverse health outcomes and/or higher utilization of services. Contractor shall determine the program’s targeted disease conditions and implement a system to identify and encourage Members to participate.
Sample 1
Disease Management Services. Subject to the terms and conditions of this DMSA, Subcontractor, as a subcontractor of ALERE, shall provide disease management services to Tufts and/or its Members in accordance with the services, functions, tasks and responsibilities described in various statements of work to be executed by Subcontractor and ALERE (each a "Statement or Work" or "SOW") (the "Disease Management Services"). Subcontractor shall perform all Disease Management Services in accordance with all applicable terms and conditions of this Agreement and all then-applicable Laws and Regulations.
Sample 1

Related to Disease Management Services

  • Construction Management Services a. A-E may be required to review and recommend approval of submittals, shop drawings, Request for Information (RFI) and/or calculations for temporary structures such as trench shoring, false work and other temporary structural forms.

  • Asset Management Services (i) Real Estate and Related Services:

  • Investment Management Services (a) The Manager shall manage the Fund’s assets subject to and in accordance with the investment objectives and policies of the Fund and any directions which the Trust’s Board of Trustees may issue from time to time. In pursuance of the foregoing, the Manager shall make all determinations with respect to the investment of the Fund’s assets and the purchase and sale of its investment securities, and shall take such steps as may be necessary to implement the same. Such determinations and services shall include determining the manner in which any voting rights, rights to consent to corporate action and any other rights pertaining to the Fund’s investment securities shall be exercised. The Manager shall render or cause to be rendered regular reports to the Trust, at regular meetings of its Board of Trustees and at such other times as may be reasonably requested by the Trust’s Board of Trustees, of (i) the decisions made with respect to the investment of the Fund’s assets and the purchase and sale of its investment securities, (ii) the reasons for such decisions and (iii) the extent to which those decisions have been implemented.

  • Inpatient Services Hospital This plan covers services provided while inpatient in a general or specialty hospital including, but not limited to the following: • anesthesia; • diagnostic tests and lab services; • dialysis; • drugs; • intensive care/coronary care; • nursing care; • physical, occupational, speech and respiratory therapies; • physician’s services while hospitalized; • radiation therapy; • surgery related services; and • room and board. Notify us if you are admitted from the emergency room to a hospital that is not in our network. Our Customer Service Department can assist you with any questions you may have about your coverage. Rehabilitation Facility This plan covers rehabilitation services received in a general hospital or specialty hospital. Coverage is limited to the number of days shown in the Summary of Medical Benefits.

  • Outpatient Services The following services are covered only at the Primary Care Provider’s office[selected by a [Member], or elsewhere [upon prior written Referral by a [Member]'s Primary Care Provider ]:

  • Development Services During the term of this Agreement, the Provider agrees to provide to or on behalf of the Port the professional services and related items described in Exhibit A (collectively, the “Development Services”) in accordance with the terms and conditions of this Agreement. The Provider specifically agrees to include at least one Port representative in any economic development negotiations or discussions in which the Provider is involved concerning (i) a port-related business prospect or (ii) a business transaction which will ultimately require Port involvement, financial or otherwise.

  • EFT SERVICES If approved, you may conduct any one (1) or more of the EFT services offered by the Credit Union.

  • Student Services 1. Students taking college classes for dual credit may utilize the same services that are available to other MCC students. MCC is responsible for ensuring timely and efficient access to such services as academic advising, learning materials (e.g., library resources), and other services for which the student may be eligible. [TAC 19, Part 1, Chapter 4, Subchapter D, §4.85 (g)(2)]

  • Administration Services When a medical prescription drug is administered by infusion, the administration of the prescription drug may be covered separately from the prescription drug. See Infusion Therapy - Administration Services in the Summary of Medical Benefits for benefit limits and the amount you pay. Prescription drugs that are self-administered are not covered as a medical benefit but may be covered as a pharmacy benefit. Please see Pharmacy Prescription Drugs and Diabetic Equipment or Supplies – Pharmacy Benefits section above for additional information. Site of Care Program For some medical prescription drugs, after the first administration, coverage may be limited to certain locations (for example, a designated outpatient or ambulatory service facility, physician’s office, or your home), provided the location is appropriate based on your medical status. For a list of medical prescription drugs that are subject to this Site of Care Program, visit our website. Preauthorization may be required to determine medical necessity as well as appropriate site of care. If we deny your request for preauthorization, or you disagree with our determination for the appropriate site of care, you can submit a medical appeal. See Appeals in Section 5 for information on how to file a medical appeal.

  • Management Services Agreement The term "Management Services ----------------------------- Agreement" shall mean this Management Services Agreement by and between Practice and Business Manager and any amendments hereto.

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