Eligibility File, Contractor Responsibilities Clause Samples
The 'Eligibility File, Contractor Responsibilities' clause defines the contractor's duty to manage and maintain accurate records of individuals eligible for certain benefits or services under the contract. Typically, this involves collecting, updating, and securely storing information such as names, identification numbers, and eligibility status, and providing timely updates to the client or relevant authorities. By clearly assigning responsibility for the eligibility file, this clause ensures that eligibility data is reliable and up-to-date, reducing the risk of errors, disputes, or lapses in coverage.
Eligibility File, Contractor Responsibilities. (A) The Contractor shall be responsible for ensuring that it is using the most recent 834 file to determine eligibility.
(B) The Contractor shall follow the policies and procedures found in the Department’s 834 Eligibility Transmission Manual, the HIPAA 834 Best Practices Manual, any amendments to these documents, and any instruction given by the Department.
Eligibility File, Contractor Responsibilities. (A) The Contractor shall be responsible for ensuring that it is using the most recent Eligibility Transmission to determine eligibility and when processing Claims.
(B) The Contractor shall follow the policies and procedures found in the Department’s 834 Benefit and Enrollment Companion Guide, the HIPAA X12 Benefit Enrollment and Maintenance (834) Implementation Guide, and any amendments to these documents. The Department shall provide any additional instruction in writing to the Contractor. Whenever possible, the Department shall give at least 30 calendar days advance notice of any changes.
Eligibility File, Contractor Responsibilities. (A) The Contractor shall be responsible for ensuring that it is using the most recent Eligibility Transmission to determine eligibility and when processing claims.
(B) The Contractor shall follow the policies and procedures found in the Department’s 834 Companion Guide, and the ASC X12 Benefit Enrollment and Maintenance (834) Implementation Guide.