Hour Coverage. Each Hospital shall be available to provide Covered Services to Covered Persons twenty-four (24) hours per day, seven (7) days per week.
Hour Coverage. Generally two (2) partners are required to cover a patient assignment for each twenty-four (24) hour period. If there are no partners available due to requested time off, medical leave, maternity/family leave, vacation, educational leave, etc., the remaining nurse may be required to revert back to an eight (8) hour shift schedule unless a volunteer is found to cover the other twelve (12) hour shift without incurring overtime. If this occurs, the remaining nurse will continue to be scheduled in accordance with the nurse’s FTE.
Hour Coverage. The Contractor shall ensure that all emergency medical care is available on a twenty-four (24) hours a day, seven (7) days a week basis through its network providers, and shall maintain, twenty-four (24) hours per day, seven (7) days per week, telephone coverage to instruct Program members on where to receive emergency and urgent health care. The Contractor's network provider/subcontractor may elect to provide twenty-four (24) hour coverage by direct access or through arrangement with a triage system. The triage system arrangement must be prior approved by SCDHHS.
Hour Coverage. The Contractor shall ensure that all emergency medical care is available on a twenty-four (24) hours a day, seven (7) days a week basis through its network providers, and shall maintain, twenty-four
Hour Coverage. Each Hospital shall be available to provide Covered Services to Covered Persons 24
Hour Coverage. The Contractor shall maintain adequate provider network coverage to serve the entire eligible populations in geographically accessible locations within the region twenty- four (24) hours per day, seven (7) days a week. The Contractor shall make arrangements to refer members seeking care after regular business hours to a covering physician or shall direct the member to go to the emergency room when a covering physician is not available. Such referrals may be made via a recorded message. In accordance with the Code of Virginia § 38.2 - 4312.3, as amended, the Contractor shall maintain after-hours telephone service, staffed by appropriate medical personnel, which includes access to a physician on call, a primary care physician, or a member of a physician group for the purpose of rendering medical advice, determining the need for emergency and other after-hours services, authorizing care, and verifying member enrollment with the Contractor. TRAVEL TIME AND DISTANCE STANDARD In accordance with 42 CFR §438.68 (b) and pursuant to NCQA’s Network Adequacy- Related Standards, the Contractor must ensure that the travel time or travel distance requirements listed below in Section 4.8.A and 4.8.B are met. In addition, pursuant to 42 CFR §438.68 (b)(viii), the Contractor must adhere to the time standards for any additional provider types when it promotes the objectives of the Medicaid program for the provider type to be subject to time and distance access standards, as determined by the Centers for Medicare & Medicaid Services (CMS).
Hour Coverage. Provide all emergency contract services and post-stabilization services as defined in this Contract 24 hours each day, 7 days a week, either by the HMO's own facilities or through arrangements approved by the Department with other providers. The HMO shall have one (1) toll-free phone number that enrollees or individuals acting on behalf of an enrollee can call at any time to obtain authorization for emergency transport, emergency, or urgent care. (Authorization here refers to the requirements defined in Addendum V, in the Standard Enrollee Handbook Language, regarding the conditions under which an enrollee must receive permission from the HMO prior to receiving services from a non-HMO affiliated provider in order for the HMO to reimburse the provider: e.g., for urgent care, for ambulance services for non-emergency care, for extended emergency services, and other situations.) This number must have access to individuals with authority to authorize treatment as appropriate. A response to such call must be provided within 30 minutes (except that response to ambulance calls shall be within 15 minutes) or the HMO will be liable for the cost of subsequent care related to that illness or injury incident whether treatment is in- or out-of-plan and whether the condition is emergency, urgent, or routine. The HMO must be able to communicate with a caller in the language spoken by the caller or the HMO will be liable for the cost of subsequent care related to that illness or injury incident whether treatment is in- or out-of-plan and whether the condition is emergency, urgent, or routine. HMO Contract for January 1, 2000 - December 31, 2001 These calls must be logged with time, date and any pertinent information related to persons involved, resolution and follow-up instructions. The HMO shall notify the Department of any changes of this one toll- free phone number for emergency calls within 7 working days of change.
Hour Coverage. The Contractor shall maintain adequate provider network coverage to serve the entire eligible populations in geographically accessible locations within the region twenty- four (24) hours per day, seven (7) days a week. The Contractor shall make arrangements to refer members seeking care after regular business hours to a covering physician or shall direct the member to go to the emergency room when a covering physician is not available. Such referrals may be made via a recorded message. In accordance with the Code of Virginia § 38.2 - 4312.3, as amended, the Contractor shall maintain after-hours telephone service, staffed by appropriate medical personnel, which includes access to a physician on call, a primary care physician, or a member of a physician group for the purpose of rendering medical advice, determining the need for emergency and other after-hours services, authorizing care, and verifying member enrollment with the Contractor. TRAVEL TIME AND DISTANCE STANDARD Pursuant to NCQA’s Network Adequacy-Related Standards, the Contractor must ensure that the travel time or travel distance requirements listed below in Section4.8.A and 4.8.B are met.
Hour Coverage. Responsibility The IHCP shall be responsible twenty-four (24) hours each day, seven (7) days a week for providing members with services necessary to support outcomes including: Immediate access to urgent and emergency services needed immediately to protect health and safety; Access to services in the benefit package; Coordination of services that remain Medicaid fee-for-service for Family Care members who are Medicaid beneficiaries; and Linkages to Adult Protective Services.
Hour Coverage. In the event the Company designates a particular position have twenty-four (24) hour coverage, with the employee or employees covering such position using a “pager” and working from their homes outside of their normal work hours, the following conditions will apply:
