FUNCTIONS AND CAPABILITIES Sample Clauses

FUNCTIONS AND CAPABILITIES. A. Prior Authorizations. The Contractor shall provide an automated system that includes the following: 1. Enrollee eligibility, utilization, and Care Management information. 2. Edits to ensure enrollee is eligible, provider is eligible, and service is covered. 3. Predefined treatment criteria to aid in adjudicating the requests. 4. Notification to provider of approval or denial including specific reason for denial. 5. Notification to enrollees of any denials or cutbacks of service. 6. Interface with claims processing system for editing and payment.
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FUNCTIONS AND CAPABILITIES. Produces standard, TDH-required reports and ad hoc reports from the data available in all MIS subsystems. All reports will be submitted as a paper copy or electronically in a format approved by TDH.
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FUNCTIONS AND CAPABILITIES. ACES The ACES System was built using IBM IMS as a base and COBOL for the primary development language. The system has evolved since inception and now the legacy system is presently being decoupled and new functionality is being introduced using technologies like Java, web services, DB2, WebSphere MQ, and iLog rules engine. The high-level business functions that ACES supports are: letters and correspondence, case management, Interactive Voice Response (IVR), benefit verification, eligibility determination, address verification, and enrollment. Washington Connection Washington Connection serves as a self-service portal where individuals and families can check their potential eligibility for social and health programs and submit applications. The major software components of Washington Connection include Websphere MQ Enterprise Service Bus, iLog rules engine, DB2, SQL Server, and Tivoli Identity Management. Data Collected through Washington Connection is sent to ACES for eligibility determination. Enhancements planned for 2011 include the ability to report eligibility changes. ProviderOne ProviderOne, the state’s MMIS system, adjudicates claims, processes payments and acts as the central data and reporting repository. The system was implemented May 9th, 2010 with no major modification since the release. The core business functions the system provides are: client and provider services, managed care, work management, coordination of benefits (COB), claims processing, social services billing and payment (SSBP), and prior authorization. Ancillary components that interface with the core ProviderOne core include: correspondence, pharmacy point of sale, Oracle Financials, call center and integrated voice recognition (IVR), imaging, data warehouse, and federal reporting. OneHealthPort - Washington HIE Washington State Senate Bill 5501 established HCA oversight for development of Health Information Exchange (HIE) in the state; HCA choose OneHealthPort (OHP) to manage the implementation of the HIE. OneHealthPort was created by a coalition of health plans, physicians and hospitals and has multiple accountabilities to its Board, and the HCA serving as the state coordinating body. The high level business functions that the OneHealthPort system supports are: exchange health care information in secure fashion, X12 EDI, HL7, NCPDP transactions, trading partner management, provider registry, credentialing service, secure authentication, and Single Sign-On. Department of Socia...
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FUNCTIONS AND CAPABILITIES. II-12 3.5.2 REPORTING REQUIREMENTS........................................ III-12 3.6
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FUNCTIONS AND CAPABILITIES. II-13 3.6.2 REPORTING PRODUCTS............................................ III-14 3.7 QUALITY ASSURANCE...................................................... III-14 3.7.1
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FUNCTIONS AND CAPABILITIES. III-14 3.7.2 REPORTING PRODUCTS.......................................III-16 3.8 MANAGEMENT AND ADMINISTRATIVE REPORTING..........................III-16 3.8.1 GENERAL REQUIREMENTS.....................................III-16 3.8.2
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Related to FUNCTIONS AND CAPABILITIES

  • Capabilities A. The Parties agree that the DRE must possess the legal, technical, and financial capacity to: (1) Accept and expend non-federal funds consistent with Section 4.2.4; (2) Accept transfer of the FERC license and title for the Facilities from PacifiCorp; (3) Seek and obtain necessary permits and other authorizations to implement Facilities Removal; (4) Enter into appropriate contracts and grant agreements for effectuating Facilities Removal; (5) Perform, directly or by oversight, Facilities Removal; (6) Prevent, mitigate, and respond to damages the DRE or any of its contractors, subcontractors, or assigns cause during the course of Facilities Removal, and, consistent with Applicable Law, respond to and defend associated liability claims against the DRE or any of its contractors, subcontractors, or assigns, including costs thereof and any judgments or awards resulting therefrom; (7) Carry the required insurance and bonding set forth in Appendix L to respond to liability and damages claims associated with Facilities Removal against the DRE or any of its contractors, subcontractors, or assigns; (8) Meet the deadlines set forth in Exhibit 4; and (9) Perform such other tasks as are reasonable and necessary for Facilities Removal. B. Before the DRE and PacifiCorp file the joint application to transfer the license for the Facilities, the DRE will Timely demonstrate to the reasonable satisfaction of the States and PacifiCorp that it possesses the legal, technical, and financial capacity to accomplish the tasks in Sections 7.1.2.A(1) through (5), (8), and (9). PacifiCorp and the States will consult if the DRE fails to make the demonstration required in this subsection. C. Within six months of the DRE’s execution of the Settlement, the DRE will include in an informational filing in the FERC license transfer proceeding proof that it possesses the legal, technical, and financial capacity to accomplish the tasks in Sections 7.1.2.A(6) and (7). This filing will include documentation that the DRE meets the requirements of Parts II, III, and IV of Appendix L and is capable of fulfilling its obligations under Section 7.1.3. The DRE will not provide the filing if either of the States or PacifiCorp objects to the filing after a reasonable opportunity to review before submission to FERC. The six-month deadline may be changed by agreement of the DRE, the States, and PacifiCorp. The Parties will Meet and Confer if the DRE fails to provide the informational filing to FERC.

  • OPERATIONAL CAPABILITY Contractor represents and warrants, as previously certified in Contractor’s Bidder’s Certification, that Contractor has the operational and financial capability to perform the Contract.

  • Skills and Abilities (i) Ability to communicate effectively both verbally and in writing. (ii) Ability to deal with others effectively. (iii) Physical ability to carry out the duties of the position. (iv) Ability to organize work. (v) Ability to operate related equipment.

  • Data Necessary to Perform Services The Trust or its agent shall furnish to USBFS the data necessary to perform the services described herein at such times and in such form as mutually agreed upon.

  • WORKPLACE FLEXIBILITY The employer must ensure that any Individual Flexibility Agreement (IFA) is genuinely agreed to by the employer and the employee and result in the employee being better off overall at the time the IFA is made than the employee would have been if no IFA had been agreed to. 8.1 Notwithstanding any other provision of the Agreement, the employer and an individual employee may agree to vary the application of certain terms of the Agreement to meet the genuine individual needs of the employer and the individual employee. The terms the employer and the individual employee may agree to vary are the application of those permitted under Section 172 of the FW Act, and relates only to:- 8.1.1 arrangements for when work is performed; 8.1.2 salary sacrifice arrangements; 8.1.3 reduction in ordinary hours; and 8.1.4 are not unlawful terms under Section 194 of the FW Act. 8.2 The employer and the individual employee must have genuinely made the IFA without coercion or duress. An IFA can only be entered into after the individual employee has commenced employment with the employer. 8.3 The IFA between the employer and the individual employee must: 8.3.1 be confined to a variation in the application of one or more of the terms listed in Clause 8.1; and 8.4 The IFA between the employer and the individual employee must also: 8.4.1 be in writing, name the parties to the IFA and be signed by the employer and the individual employee and, if the employee is under eighteen (18) years of age, the employee’s parent or guardian; 8.4.2 state each term of the Agreement that the employer and the individual employee have agreed to vary; 8.4.3 detail how the application of each term has been varied by agreement between the employer and the individual employee;