Enrollees Sample Clauses

Enrollees. Any individual(s) entitled to health care benefits under a Plan who presents an identification card that contains the following information:
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Enrollees. A. Policies and procedures. The contractor shall establish written policies and procedures for identifying potential enrollee fraud and abuse. Proven cases are to be referred to the Department for screening for advice and/or assistance on follow-up actions to be taken. Referrals are to be accompanied by all supporting case documentation.
Enrollees. Each Company has made available to Purchaser true, correct and complete copies of the most recent Enrollment Files made available to each Company prior to the Effective Date (the “Signing Enrollment Files”). When delivered to Purchaser pursuant to Section 2.05 hereof, the Closing Enrollment Files or the most recent Enrollment Files shall be true, correct and complete copies thereof.
Enrollees. The books and records to be delivered to Purchaser will contain all material information that such Company is required to maintain or is required to submit to a Governmental Authority under the terms of its Contracts with Payors (and applicable Laws, rules and regulations), and all such material information delivered to Purchaser will be, upon delivery, correct and complete in all material respects. Except as set forth on Section 5.25 of the Seller Disclosure Schedule, the Companies have not received any Grievances (as defined by applicable Law) from an Enrollee during the twelve (12) month period prior to May 31, 2023 other than those that are, individually and in the aggregate, immaterial.
Enrollees 

Related to Enrollees

  • Disenrollment 2.3.2.1. The Contractor shall:

  • Patients The Dentist shall accept Covered Persons as patients as reasonably permitted by the Dentist's patient load and appointment calendar. The Dentist will provide Covered Dental Services to Covered Persons on the same basis as to the Dentist's other patients (for example: scheduling, quality of service, and fee charges). The Dentist will be solely responsible to Covered Persons for dental advice and treatment; SDC will have no control over Dentist's practice or the dentist-patient relationship.

  • Contractor Key Personnel ‌ The Contractor shall assign a Corporate OASIS Program Manager (COPM) and Corporate OASIS Contract Manager (COCM) as Contractor Key Personnel to represent the Contractor as primary points-of-contact to resolve issues, perform administrative duties, and other functions that may arise relating to OASIS and task orders solicited and awarded under XXXXX. Additional Key Personnel requirements may be designated by the OCO at the task order level. There is no minimum qualification requirements established for Contractor Key Personnel. Additionally, Contractor Key Personnel do not have to be full-time positions; however, the Contractor Key Personnel are expected to be fully proficient in the performance of their duties. The Contractor shall ensure that the OASIS CO has current point-of-contact information for both the COPM and COCM. In the event of a change to Contractor Key Personnel, the Contractor shall notify the OASIS CO and provide all Point of Contact information for the new Key Personnel within 5 calendar days of the change. All costs associated with Contractor Key Personnel duties shall be handled in accordance with the Contractor’s standard accounting practices; however, no costs for Contractor Key Personnel may be billed to the OASIS Program Office. Failure of Contractor Key Personnel to effectively and efficiently perform their duties will be construed as conduct detrimental to contract performance and may result in activation of Dormant Status and/or Off-Ramping (See Sections H.16. and H.17.).

  • Patient A patient is defined as those persons for whom the Physician shall provide Services, and who are signatories to, or listed on the documents attached as Appendix 1, and incorporated by reference, to this agreement.

  • Physician Visits This plan covers the services of a physician or other provider in charge of your medical care while you are inpatient in a general or specialty hospital.

  • Supplier Diversity Seller shall comply with Xxxxx’s Supplier Diversity Program in accordance with Appendix V.

  • Medical Verification The Town may require medical verification of an employee’s absence if the Town perceives the employee is abusing sick leave or has used an excessive amount of sick leave. The Town may require medical verification of an employee’s absence to verify that the employee is able to return to work with or without restrictions.

  • Health Plan An appropriately licensed entity that has entered into a contract with Subcontractor, either directly or indirectly, under which Subcontractor provides certain administrative services for Health Plan pursuant to the State Contract. For purposes of this Appendix, Health Plan refers to UnitedHealthcare Insurance Company.

  • Diagnosis For a condition to be considered a covered illness or disorder, copies of laboratory tests results, X-rays, or any other report or result of clinical examinations on which the diagnosis was based, are required as part of the positive diagnosis by a physician.

  • Provider Network The Panel of health service Providers with which the Contractor contracts for the provision of covered services to Members and Out-of-network Providers administering services to Members.

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