Member Hotline Sample Clauses

Member Hotline. The HMO must operate a toll-free hotline that Members can call 24 hours a day, seven (7) days a week. The Member Hotline must be staffed with personnel who are knowledgeable about its HMO Program(s) and Covered Services, between the hours of 8:00 a.m. to 5:00 p.m. local time for the Service Area, Monday through Friday, excluding state-approved holidays. The HMO must ensure that after hours, on weekends, and on holidays the Member Services Hotline is answered by an automated system with the capability to provide callers with operating hours and instructions on what to do in cases of emergency. All recordings must be in English and in Spanish. A voice mailbox must be available after hours for callers to leave messages. The HMO’s Member Services representatives must return member calls received by the automated system on the next working day. If the Member Hotline does not have a voice-activated menu system, the HMO must have a menu system that will accommodate Members who cannot access the system through other physical means, such as pushing a button. The HMO must ensure that its Member Service representatives treat all callers with dignity and respect the callers’ need for privacy. At a minimum, the HMO’s Member Service representatives must be:
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Member Hotline. (3 pages, plus 2 additional pages per additional MCO Program bid if the Respondent’s response differs by MCO Program; excluding hotline telephone reports) The Member Hotline requirements are described in Section 8.1.5.6. Describe the proposed Member Hotline function, including:
Member Hotline. The MCO must operate a toll-free hotline that Members can call 24 hours a day, seven (7) days a week. The Member Hotline must be staffed with personnel who are knowledgeable about its MCO Program(s) and Covered Services between the hours of 8:00 a.m. to 5:00 p.m. local time for the Service Area, Monday through Friday, excluding state-approved holidays. The State-approved holiday schedule is updated annually and can be found at xxxx://xxx.xx.xxxxx.xx.xx/compensation/holidays.html. The MCO must ensure that after hours, on weekends, and on holidays the Member Services Hotline is answered by an automated system with the capability to provide callers with operating hours and instructions on what to do in cases of emergency. All recordings must be in English, Spanish, and the languages of other Major Population Groups in the Service Area. A voice mailbox must be available after hours for callers to leave messages. The MCO's Member Services representatives must return calls received by the automated system from Members or their representatives on the next Business Day. If the Member Hotline does not have a voice-activated menu system, the MCO must have a menu system that will accommodate Members who cannot access the system through other physical means, such as pushing a button. The MCO must ensure that its Member Service representatives treat all callers with dignity and respect the callers' need for privacy. At a minimum, the MCO's Member Service representatives must be:
Member Hotline. HMO must maintain a toll-free Member telephone hotline 24 hours a day, seven days a week for Members to obtain assistance in accessing services under this contract. Telephone availability must be demonstrated through an abandonment rate of less than 10%.
Member Hotline. 85 8.6 MEMBER COMPLAINT PROCESS.......................................................85 8.7 MEMBER NOTICE, APPEALS AND FAIR HEARINGS.......................................88 8.8 MEMBER ADVOCATES...............................................................89 8.9
Member Hotline. The HMO must operate a toll-free hotline that Members can call 24 hours a day, seven (7) days a week. The Member Hotline must be staffed with personnel who are knowledgeable about its HMO Program(s) and Covered Services, between the hours of 8:00 a.m. to 5:00 p.m. local time for the Service Area, Monday through Friday, excluding state-approved holidays. Contractual Document (CD) Responsible Office: HHSC Office of General Counsel (OGC) Subject: Attachment B-1 – HHSC Joint Medicaid/CHIP HMO RFP, Section 8 Version 1.0 The HMO must ensure that after hours, on weekends, and on holidays the Member Services Hotline is answered by an automated system with the capability to provide callers with operating hours and instructions on what to do in cases of emergency. All recordings must be in English and in Spanish. A voice mailbox must be available after hours for callers to leave messages. The HMO’s Member Services representatives must return member calls received by the automated system on the next working day. If the Member Hotline does not have a voice-activated menu system, the HMO must have a menu system that will accommodate Members who cannot access the system through other physical means, such as pushing a button. The HMO must ensure that its Member Service representatives treat all callers with dignity and respect the callers’ need for privacy. At a minimum, the HMO’s Member Service representatives must be:
Member Hotline. The MCO must establish a single toll-free telephone number to assist with questions that members may have about the MCO's providers or benefits. In accordance with 42 CFR 438.10(c), the MCO must satisfy each of the following requirements: - Provide a description of the oral interpretation services offered to members - Notify members of the availability of free oral interpretation services for all languages - Make free oral interpretation services available for all languages
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Member Hotline. 73 8.6 MEMBER COMPLAINT PROCESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 8.7 MEMBER NOTICE, APPEALS AND FAIR HEARINGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 8.8

Related to Member Hotline

  • PRE-JOB CONFERENCE Section 1. Upon written request by either Party, a pre-job conference will be held prior to the time the Employees of such Employer begin work on the project.

  • Board Member Training Within 90 days after the Effective Date, each member of the Board of Directors shall receive at least two hours of training. This training shall address the corporate governance responsibilities of board members, and the responsibilities of board members with respect to review and oversight of the Compliance Program. Specifically, the training shall address the unique responsibilities of health care Board members, including the risks, oversight areas, and strategic approaches to conducting oversight of a health care entity. This training may be conducted by an outside compliance expert hired by the Board and should include a discussion of the OIG’s guidance on Board member responsibilities.‌ New members of the Board of Directors shall receive the Board Member Training described above within 30 days after becoming a member or within 90 days after the Effective Date, whichever is later.

  • Parent-Teacher Conferences A. Unit member shall be available at mutually arranged times during the regular school day to confer with parents regarding learning difficulties, student progress and/or behavioral problems a student may be experiencing. Unit members are encouraged to arrange a meeting or conference with parents before or after the regular school day if both time and place are mutually agreeable.

  • Member The Member owns 100% of the limited liability company interests in the Company.

  • Multi-Member The Members, or their designees, shall maintain complete and accurate records and books of the Company’s transactions in accordance with generally accepted accounting principles. The Company shall furnish each Member, within seventy-five days after the end of each fiscal year, an annual report of the Company including a balance sheet, a profit and loss statement a capital account statement; and the amount of such Member’s share of the Company’s income, gain, losses, deductions and other relevant items for federal income tax purposes. The Company shall prepare all Federal, State and local income tax and information returns for the Company, and shall cause such tax and information returns to be timely filed. Within seventy-five days after the end of each fiscal year, the Company shall forward to each person who was a Member during the preceding fiscal year a true copy of the Company’s information return filed with the Internal Revenue Service for the preceding fiscal year. All elections required or permitted to be made by the Company under the Internal Revenue Code, and the designation of a tax matters partner pursuant to Section 6231(a)(7) of the Internal Revenue Code for all purposes permitted or required by the Code, shall be made by the Company by the affirmative vote or consent of Members holding a majority of the Members’ Percentage Interests. Upon request, the Company shall furnish to each Member, a current list of the names and addresses of all of the Members of the Company, and any other persons or entities having any financial interest in the Company.

  • Research Independence The Company acknowledges that each Underwriter’s research analysts and research departments, if any, are required to be independent from their respective investment banking divisions and are subject to certain regulations and internal policies, and that such Underwriter’s research analysts may hold and make statements or investment recommendations and/or publish research reports with respect to the Company and/or the offering that differ from the views of its investment bankers. The Company hereby waives and releases, to the fullest extent permitted by law, any claims that the Company may have against such Underwriter with respect to any conflict of interest that may arise from the fact that the views expressed by their independent research analysts and research departments may be different from or inconsistent with the views or advice communicated to the Company by such Underwriter’s investment banking divisions. The Company acknowledges that the Representative is a full service securities firm and as such from time to time, subject to applicable securities laws, may effect transactions for its own account or the account of its customers and hold long or short position in debt or equity securities of the Company.

  • Submitting Loop Makeup Service Inquiries 2.9.2.1 C.M. may obtain LMU information by submitting a mechanized LMU query or a Manual LMUSI. Mechanized LMUs should be submitted through BellSouth's OSS interfaces. After obtaining the Loop information from the mechanized LMU process, if C.M. needs further Loop information in order to determine Loop service capability, C.M. may initiate a separate Manual Service Inquiry for a separate nonrecurring charge as set forth in Exhibit A of this Attachment.

  • Financial Public Relations Firm Promptly after the execution of a definitive agreement for a Business Combination, the Company shall retain a financial public relations firm reasonably acceptable to the Representative for a term to be agreed upon by the Company and the Representative.

  • Member Handbook The Contractor shall develop a member handbook for its members. The Contractor’s member handbook shall be submitted annually for OMPP’s review. The member handbook shall include the Contractor’s contact information and Internet website address and describe the terms and nature of services offered by the Contractor, including the following information required under 42 CFR 438.10(f), which enumerates certain required information. The member handbook may be offered in an electronic format as long as the Contractor complies with 42 CFR 438.10(c)(6). The Hoosier Healthwise MCE Policies and Procedures Manual outlines the member handbook requirements. The Hoosier Healthwise member handbook shall include the following:  Contractor’s contact information (address, telephone number, TDD number, website address);  The amount, duration and scope of services and benefits available under the Contract in sufficient details to ensure that participants are informed of the services to which they are entitled, including, but not limited to the differences between the benefit options;  The procedures for obtaining benefits, including authorization requirements;  Contractor’s office hours and days, including the availability of a 24-hour Nurse Call Line;  Any restrictions on the member’s freedom of choice among network providers, as well as the extent to which members may obtain benefits, including family planning services, from out-of-network providers;  The extent to which, and how, after-hours and emergency coverage are provided, as well as other information required under 42 CFR 438.10(f), such as what constitutes an emergency;  The post-stabilization care services rules set forth in 42 CFR 422.113(c);  The extent to which, and how, urgent care services are provided;  Applicable policy on referrals for specialty care and other benefits not provided by the member’s PMP, if any;  Information about the availability of pharmacy services and how to access pharmacy services;  Member rights and protections, as enumerated in 42 CFR 438.100, which relates to enrollee rights. See Section 4.8 for further detail regarding member rights and protections;  Responsibilities of members;  Special benefit provisions (for example, co-payments, deductibles, limits or rejections of claims) that may apply to services obtained outside the Contractor’s network;  Procedures for obtaining out-of-network services;  Standards and expectations to receive preventive health services;  Policy on referrals to specialty care;  Procedures for notifying members affected by termination or change in any benefits, services or service delivery sites;  Procedures for appealing decisions adversely affecting members’ coverage, benefits or relationship with the Contractor;  Procedures for changing PMPs;  Standards and procedures for changing MCEs, and circumstances under which this is possible, including, but not limited to providing contact information and instructions for how to contact the enrollment broker to transfer MCEs due to one of the “for cause” reasons described in 42 CFR 438.56(d)(2)(iv), including, but not limited to, the following:  Receiving poor quality of care;  Failure to provide covered services;  Failure of the Contractor to comply with established standards of medical care administration;  Lack of access to providers experienced in dealing with the member’s health care needs;  Significant language or cultural barriers;  Corrective action levied against the Contractor by the office;  Limited access to a primary care clinic or other health services within reasonable proximity to a member’s residence;  A determination that another MCE’s formulary is more consistent with a new member’s existing health care needs;  Lack of access to medically necessary services covered under the Contractor’s contract with the State;  A service is not covered by the Contractor for moral or religious objections, as described in Section 6.3.3;  Related services are required to be performed at the same time and not all related services are available within the Contractor’s network, and the member’s provider determines that receiving the services separately will subject the member to unnecessary risk;  The member’s primary healthcare provider disenrolls from the member’s current MCE and reenrolls with another MCE; or  Other circumstances determined by the office or its designee to constitute poor quality of health care coverage.  The process for submitting disenrollment requests. This information shall include the following:  Hoosier Healthwise members may change MCEs after the first ninety (90) calendar days of enrollment only for cause;  Members are required to exhaust the MCE’s internal grievance and appeals process before requesting an MCE change ;  Members may submit requests to change MCEs to the Enrollment Broker verbally or in writing, after exhausting the MCE’s internal grievance and appeals process; and  The MCE shall provide the Enrollment Broker’s contact information and explain that the member must contact the Enrollment Broker with questions about the process. This information shall include how to obtain the Enrollment Broker’s standardized form for requesting an MCE change.  The process by which an American Indian/ Alaska Native member may elect to opt-out of managed care pursuant to 42 USC § 1396u–2(a)(2)(C) and transfer to fee-for-service benefits through the State;  Procedures for making complaints and recommending changes in policies and services;  Grievance, appeal and fair hearing procedures as required at 42 CFR 438.10(g)(2)(xi), including the following:  The right to file grievances and appeals;  The requirements and timeframes for filing a grievance or appeal;  The availability of assistance in the filing process;  The toll-free numbers that the member can use to file a grievance or appeal by phone;  The fact that, if requested by the member and under certain circumstances: (1) benefits will continue if the member files an appeal or requests a State fair hearing within the specified timeframes; and (2) the member may be required to pay the cost of services furnished during the appeal if the final decision is adverse to the member.  For a State hearing describe (i) the right to a hearing, (ii) the method for obtaining a hearing, and (iii) the rules that govern representation at the hearing.  Information about advance directives;  How to report a change in income, change in family size, etc.;  Information about the availability of the prior claims payment program for certain members and how to access the program administrator;  Information on alternative methods or formats of communication for visually and hearing-impaired and non-English speaking members and how members can access those methods or formats;  Information on how to contact the Enrollment Broker;  Statement that Contractor will provide information on the structure and operation of the health plan; and  In accordance with 42 CFR 438.10(f)(3), that upon request of the member, information on the Contractor’s provider incentive plans will be provided.

  • LICENSE HOLDER CONTACT INFORMATION This noƟce is being provided for informaƟon purposes. It does not create an obligaƟon for you to use the broker’s services. Please acknowledge receipt of this noƟce below and retain a copy for your records. Davidson Bogel Real Estate, LLC 9004427 xxxx@xx0xx.xxx 214-526-3626 Licensed Broker /Broker Firm Name or Primary Assumed Business Name License No. Email Phone Xxxxxxx Xxxxxx Xxxxx XX 598526 xxxxxx@xx0xx.xxx 214-526-3626 Designated Broker of Firm License No. Email Phone Xxxxxxxxxxx Xxxx Xxxxxx 672133 xxxxxxx@xx0xx.xxx 214-526-3626 Licensed Supervisor of Sales Agent/ Associate License No. Email Phone N/A N/A N/A N/A Sales Agent/Associate’s Name License No. Email Phone Buyer/Tenant/Seller/Landlord Initials Date Regulated by the Texas Real Estate Commission InformaƟon available at xxx.xxxx.xxxxx.xxx

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