Eligibility and Benefit Verification Sample Clauses

Eligibility and Benefit Verification. BCBSM will provide Facility with a system and/or method to promptly verify eligibility and benefit coverages of Members; provided that any verification will be given as a service and not as a guarantee of payment.
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Eligibility and Benefit Verification. BCBS will provide Facility with a system and/or method to verify eligibility and benefit coverages of Members; provided that any such verification will be given as a service and not as a guarantee of payment.
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Eligibility and Benefit Verification. HealthAmerica or other Member Company shall be responsible for the determination under each Program as to whether (i) a person receiving services, supplies, products or accommodations from an AHERF Provider is a Covered Individual, and (ii) the services, supplies, products and accommodation provided to a Covered Individual are Covered Services. The Member Company shall use its reasonable efforts to provide AHERF and AHERF Providers with real time access to the Member Company's eligibility files to verify a Covered Individual's eligibility and coverage. HealthAmerica agrees that such verification process shall be reasonable and consistently and uniformly applied to each HealthAmerica Participating Provider. HealthAmerica shall make eligibility determinations according to its then current policies. As to AHERF Providers being compensated on a capitation basis, if a Covered Individual's eligibility has been canceled retroactively, HealthAmerica may deduct from payments to be made to the AHERF Provider an amount equal to the capitation payments paid to the AHERF Provider on account of such Covered Individual after the date of the retroactive cancellation: provided, however, such amount shall not exceed an amount equal to three (3) months of capitation payments for such Covered Services. The AHERF Provider may bill xxxh Covered Individual for services rendered during such period of ineligibility, which billing shall not constitute a violation of Sections 5.9. If a Covered Individual's enrollment in an AHERF Provider's practice has been added retroactively for three (3) or more months, HealthAmerica shall make a capitation payment equal to three months of capitation payments for such Covered Individual. The foregoing financial terms and conditions shall be AHERF Provider's sole and exclusive remedy for failing to notify HealthAmerica or Member Company of a Covered Individual's enrollment in an AHERF Provider's practice. AHERF Providers shall provide health care services to Covered Individuals without prior verification of eligibility or authorization in cases of an emergency.
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Eligibility and Benefit Verification. BCBSM will provide CRNA with a system and/or method to promptly verify eligibility and benefit coverages of Members; provided that any such verification by BCBSM will be given as a service and not as a guarantee of payment.
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Eligibility and Benefit Verification. Plan shall be responsible for the determination whether (i) a person receiving services, supplies, products or accommodations from a BJC Provider is a BJC Medicaid Member, and (ii) the services, supplies, products and accommodation provided to a BJC Medicaid Member are Covered Services. Plan shall provide BJC with the claims and eligibility reports attached hereto as EXHIBIT E and Plan shall use its reasonable efforts to provide BJC and BJC Providers in the future with real time access to Plan's eligibility files to verify BJC Medicaid Member eligibility and coverage. Plan agrees that its eligibility verification processes shall be reasonable and consistently and uniformly applied to each BJC Provider. Plan shall make eligibility determinations according to its then current policies.
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Eligibility and Benefit Verification. Provider will be responsible for verifying Member eligibility and coverage through such processes as BCBSM shall establish from time to time.
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Eligibility and Benefit Verification. Plan shall be responsible for the determination under each Benefit Plan covered under the scope of this Exhibit as to whether (i) a person receiving services, supplies, products or accommodations from a BJC Provider is a BJC Medicare Member, and (ii) the services, supplies, products and accommodation provided to a BJC Medicare Member are Covered Services. Plan shall provide BJC the claims and eligibility reports set forth in EXHIBIT E and shall use its reasonable efforts to provide BJC and BJC Providers in the future with real time access to Plan's eligibility files to verify BJC Medicare Member eligibility and coverage. Plan agrees that its eligibility verification processes shall be reasonable and consistently and uniformly applied to each BJC Provider. Plan shall make eligibility determinations according to its then current policies.
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Eligibility and Benefit Verification. Plan shall be responsible for the determination under each Benefit Plan covered under the scope of this Exhibit as to whether (i) a person receiving services, supplies, products or accommodations from a BJC Provider is a Member, and
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Related to Eligibility and Benefit Verification

  • Employee Eligibility Verification The Contractor warrants that it fully complies with all Federal and State statutes and regulations regarding the employment of aliens and others and that all its employees performing work under this Contract meet the citizenship or alien status requirement set forth in Federal statutes and regulations. The Contractor shall obtain, from all employees performing work hereunder, all verification and other documentation of employment eligibility status required by Federal or State statutes and regulations including, but not limited to, the Immigration Reform and Control Act of 1986, 8 U.S.C. §1324 et seq., as they currently exist and as they may be hereafter amended. The Contractor shall retain all such documentation for all covered employees for the period prescribed by the law. The Contractor shall indemnify, defend with counsel approved in writing by County, and hold harmless, the County, its agents, officers, and employees from employer sanctions and any other liability which may be assessed against the Contractor or the County or both in connection with any alleged violation of any Federal or State statutes or regulations pertaining to the eligibility for employment of any persons performing work under this Contract.

  • Employment Eligibility Verification As required by IC § 22-5-1.7, the Contractor swears or affirms under the penalties of perjury that the Contractor does not knowingly employ an unauthorized alien. The Contractor further agrees that:

  • Overtime Eligibility and Compensation Employees are eligible for overtime compensation under the following circumstances:

  • Benefit Eligibility For purposes of the Benefit Plan entitlement, common-law and same sex relationships will apply as defined.

  • Verification of Employment Eligibility By executing this Agreement, Consultant verifies that it fully complies with all requirements and restrictions of state and federal law respecting the employment of undocumented aliens, including, but not limited to, the Immigration Reform and Control Act of 1986, as may be amended from time to time, and shall require all subconsultants and sub-subconsultants to comply with the same.

  • Synopsis and Benefit to Xxxxxxx County Xxxxxxx County has been working with the State of Oregon for several years to provide correctional services for the supervision of Senate Bill 1145 cases. Xxxxxxx County is assigned responsibility for all offenders on probation, parole, post-prison supervision, and those offenders sentenced or revoked for periods of one year or less, and on conditional release to the County. The State reimburses the County for expenses associated with housing and supervision of these offenders through Community Corrections Act Funding.

  • Overtime Eligibility An Employee must work at least fifteen (15) minutes beyond her normal shift before being eligible for overtime compensation.

  • Eligibility and Enrollment 2.3.1 The State of Georgia has the sole authority for determining eligibility for the Medicaid program and whether Medicaid beneficiaries are eligible for Enrollment in GF. DCH or its Agent will determine eligibility for PeachCare for Kids and will collect applicable premiums. DCH or its agent will continue responsibility for the electronic eligibility verification system (EVS).

  • Workplace Safety Insurance Benefits (WSIB) Top Up Benefits If the employee is in a class of employees that, on August 31, 2012, was entitled to use unused sick leave credits for the purpose of topping up benefits received under the Workplace Safety and Insurance Act, 1997;

  • Student Eligibility A. The Texas Success Initiative (TSI) requires mandatory assessment for all students to determine college readiness in reading, writing and math. The xxxx authorizes the Texas Higher Education Coordinating Board to prescribe assessment instruments with a statewide passing standard. The initiative allows an institution to determine when a student is ready to perform college‐level coursework. High School students who seek to register in a dual credit course, which will grant college credit must prove “college readiness” by achieving a college level score as outlined in Appendix A.

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