Eligibility Files. Client will provide to Marathon on a weekly basis, or other mutually agreed-upon frequency, a Participant eligibility file, which is necessary to enable Marathon to provide the Marathon Services. The Participant eligibility file will contain the entire population of Participants and will adhere to Marathon’s file specifications.
Eligibility Files. The TPA will be required to maintain HIPAA compliant information on each participant. In addition to such information, the Board requires that the following information be captured and maintained in the TPA's eligibility system:
Eligibility Files. Client agrees to upload on MTM’s secure SFTP server, API or client portal on the first business day of each month, or agreed upon schedule a listing all active members for which MTM may provide telemedicine services under this Agreement.
Eligibility Files. Contractor shall:
Eligibility Files. Electronic transmissions: If the Eligibility File is not readable, the receiving party agrees to notify the sender within seven (7) business days from receipt of the file by telephone. The sender shall send a replacement Eligibility File to the receiving party. Until receipt of the replacement Eligibility File, the CMS Contractor will transfer claims based on the last transmitted Eligibility File that was readable and was posted to CMS’ Common Working File. If the sender does not receive a COBA Eligibility File Acknowledgement (EFA) and Eligibility Response File (ERF) within the timeframes described in the COBA Implementation Guide, the sender shall contact the CMS Contractor by telephone as listed in Section II.B of the Attachment.
Eligibility Files. Client will provide to MRS on a monthly basis a Participant eligibility file, which is necessary to enable MRS to provide the services outlined and agreed-upon in this Agreement. The Participant eligibility file will contain the updated and entire population of Participants and comply with MRS’s file specifications.
Eligibility Files. (a) CLIENT shall provide BENECARD PBF with a true, accurate and complete eligibility file, in an electronic or paper format, on a frequency mutually agreeable to CLIENT and BENECARD PBF, identifying all eligible Members and their dependents, together with all relevant information required by BENECARD PBF to process Claims and to provide its services under this Agreement. The full file format shall include CLIENT number, group code, Member I.D., effective date, last name, first name, gender, relation code, birth date, primary xxxxxx xxxxxxx, Xxxx, Xxxxx, and five (5) digit zip code for each member and dependent. Partial or change file formats must be agreed to between the parties. CLIENT shall be solely responsible for ensuring the accuracy of its eligibility records as submitted to BENECARD PBF, and shall be obligated to pay BENECARD PBF for all amounts due to BENECARD PBF hereunder for Claims for Members shown as eligible on the date the claim was adjudicated.
Eligibility Files. By the 1st day of each month, Employer, or its third party administrator, shall deliver to Teladoc Health an accurate file identifying the number of Employees eligible to utilize the HealthiestYou Virtual Care Services in that month (the “Eligibility File”) and their applicable contact information (including name, street address, and email address), in a format approved by Teladoc Health. If Employer, or its third party administrator, fails to deliver the Eligibility File by the 1st day of the month, then the last valid Eligibility File delivered to Teladoc Health will be deemed to be the Eligibility File for that month. Alternatively and as applicable, Employer may either provide Eligibility File information via Teladoc Health’s Client Site portal, or via a Real Time Eligibility (RTE) process, as mutually agreed by the Parties. If Employer subsequently requests a modification to their method of delivering Eligibility File information, Teladoc Health may charge the Employer an additional fee of two hundred dollars ($200) per hour, times that number of hours necessary to effect such modification.
Eligibility Files. Employer will provide HRH with a list of Eligible Persons who are entitled to utilize the services of the Wellness Centers, subject to Exhibit D (the "Eligibility File"), which shall include employees who are employed but on leave or who have the right under COBRA to elect to receive benefits as an Eligible Person, and all dependents of Employer’s employees that Employer desires to include as Eligible Persons. Employer will provide its Eligibility File to HRH (i) no later than thirty (30) days prior to the Commencement Date, and (ii) no later than ten (10) days prior to the first day of each month following the Commencement Date. Upon the enrollment of additional employees after the Commencement Date, Employer will provide an updated Eligibility File to HRH that includes the new or terminated employees in a form as directed by HRH and frequency as agreed upon by both parties. Any employees (including eligible dependents) added to the Eligibility File following the Commencement Date will be entitled to utilize the services of the Wellness Centers, and will be invoiced as outlined in this Agreement. If an Eligible Person becomes ineligible for Employer health benefits, Employer must provide HRH with an updated Eligibility File reflecting that the Eligible Person is no longer entitled to utilize the services of the Wellness Centers. The Eligibility File will be delivered in a format specified by HRH as set forth in Exhibit D; however, if Employer desires to use an alternative format or to establish an electronic data interface between HRH and Employer to transmit the applicable Eligibility File data, HRH will evaluate using the alternative format, including whether there are any additional costs that need to be incurred to utilize the alternative format. Identification. HRH may rely upon a government-issued identification card (for example, a driver's license) to identify Eligible Persons. If an Eligible Person permits another individual to use the Eligible Person's identification card to obtain services or the Eligible Person uses an invalid identification card to obtain services, HRH may terminate the coverage of the Eligible Person effective immediately. Any Eligible Person involved in the misuse of an identification card will be liable to HRH for the prevailing rates of any services rendered in connection with the misuse.
Eligibility Files. No later than 30 days prior to the Start Date, Client shall deliver to Best Doctors a report that lists all employees expected to be eligible to utilize the Services (“Client Employees”) as of the Start Date (the “Client Eligibility File”). Thereafter, Client shall, at a minimum, deliver monthly an updated Client Eligibility File to Best Doctors no later than the first day of each month that lists (a) all Client Employees for that month; provided, however, that if Client fails to deliver such a report before the first day of any month during the Term, then the last Client Eligibility File delivered to Best Doctors will be deemed to be the Client Eligibility File for that month. Any corrections to a Client Eligibility File must be delivered by Client to Best Doctors within 6 months following the date of submission of such file.
