Participant and Provider Customer Service Sample Clauses

Participant and Provider Customer Service. The TPA is responsible for responding to inquiries from participants, providers, and OI regarding the services provided by the TPA through a toll free telephone line. The normal service hours, in Central Standard Time, are 8:00 AM to 5:00 PM Monday through Friday. In addition, a voice message system shall be available after normal business hours, 7 days-a-week, other than scheduled maintenance times, to participants and providers. The TPA is responsible for maintaining a separate participant customer service area with a separate dedicated toll-free number for participants. The TPA must maintain a well-trained exclusive customer service department for participants capable of addressing all benefit and procedure questions. The TPA is responsible for maintaining a separate provider customer service area with a separate toll-free number for verification of participant eligibility, benefit questions, and claims status, and if requested, an estimate of allowable charges. In addition, the TPA is responsible for maintaining a self-serve system to providers for verification of participant eligibility, benefit summaries, deductible and co-insurance maximum accumulation amounts and claims status. This self-serve system must be available twenty-four (24) hours, seven (7) days a week. The TPA is responsible for maintaining an automatic call distribution system capable of tracking and reporting phone activity for both participant and provider customer service numbers. The TPA is required to participate in activities with OI in responding to participant or provider inquiries or complaints relating to TPA services. The TPA must cooperate with OI and with all other contractors of the Board with respect to ongoing coordination and delivery of health care services and in any transition of responsibilities. The TPA is responsible for responding to inquiries from employer units concerning administrative procedures and benefits.
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Related to Participant and Provider Customer Service

  • CUSTOMER SERVICE ACCESS The Competitive Supplier agrees to provide, or cause to be provided, certain customer services to Participating Consumers. Such services shall be reasonably accessible to all Participating Consumers, shall be available during normal working hours, shall allow Participating Consumers to transact business they may have with the Competitive Supplier, and shall serve as a communications liaison among the Competitive Supplier, the Town, and the Local Distributor. A toll-free telephone number will be established by Competitive Supplier and be available for Participating Consumers to contact Competitive Supplier during normal business hours (9:00 A.M. - 5:00 P.M. Eastern Standard Time, Monday through Friday) to resolve concerns, answer questions and transact business with respect to the service received from Competitive Supplier. The Town will post program-related information on the Town’s website which will be available to Participating Consumers for general information, product and service information, and other purposes.

  • Customer Service A. PRIMARY ACCOUNT REPRESENTATIVE. Supplier will assign an Account Representative to Sourcewell for this Contract and must provide prompt notice to Sourcewell if that person is changed. The Account Representative will be responsible for: • Maintenance and management of this Contract; • Timely response to all Sourcewell and Participating Entity inquiries; and • Business reviews to Sourcewell and Participating Entities, if applicable.

  • Customer Service Standards The Franchising Authority hereby adopts the customer service standards set forth in Part 76, §76.309 of the FCC’s rules and regulations, as amended. The Grantee shall comply in all respects with the customer service requirements established by the FCC.

  • PROVIDER PERSONNEL 9.1 The Department and Provider agree and acknowledge that in the event of the Provider ceasing to provide the Services or part of them for any reason, Clause 25 (Re-Provision of the Services) of the Agreement will apply.

  • CONTRACTOR CUSTOMER SERVICE REPRESENTATIVE Contractor shall designate a customer service representative (and inform Enterprise Services of the same) who shall be responsible for addressing Purchaser issues pertaining to this Master Contract.

  • Provider Services The Contractor’s system shall collect, process, and maintain current and historical data on program providers. This information shall be accessible to all parts of the MCMIS for editing and reporting.

  • B4 Key Personnel B4.1 The Contractor acknowledges that the Key Personnel are essential to the proper provision of the Services to the Authority.

  • 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.).

  • Business Associate Contract A. GENERAL PROVISIONS AND RECITALS

  • Information about Contractor Employees 23.1. The Authority may by notice require the Contractor to disclose such information as the Authority may require relating to those of the Contractor’s employees carrying out activities under or connected with the Framework Agreement.

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