Prescriptions Covered Outside the Service Area; To Get Reimbursement Sample Clauses

Prescriptions Covered Outside the Service Area; To Get Reimbursement. The Health Plan covers drugs prescribed by non-Plan Providers and purchased at non-Plan Pharmacies when the drug was prescribed during the course of an emergency care visit or an urgent care visit (see “Emergency Services” and “Urgent Care Services” sections of the Group Evidence of Coverage), or associated with a covered, authorized referral outside Health Plan’s Service Area. To get reimbursed you must submit a copy of the itemized receipts for the prescriptions to Health Plan. We may require proof that urgent or emergency care Services were provided. We will reimburse you at the Allowable Charge less the applicable Rx Copayment or Rx Coinsurance set forth in the Summary of Services and Cost Shares in the EOC to which this Rider is attached. Claims should be submitted to: Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. Attention: Claims Department
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Related to Prescriptions Covered Outside the Service Area; To Get Reimbursement

  • Outpatient emergency and urgicenter services within the service area The emergency room copay applies to all outpatient emergency visits that do not result in hospital admission within twenty-four (24) hours. The urgicenter copay is the same as the primary care clinic office visit copay.

  • Reimbursement of Travel Expenses If the Servicer provides access to the Review Materials at one of its properties, the Issuer will reimburse the Asset Representations Reviewer for its reasonable travel expenses incurred in connection with the Review on receipt of a detailed invoice.

  • Transportation Reimbursement Employees who, during the course of their normal duties, are required to actually transport clients/consumers/felons in their own personal vehicle on a regular basis, are eligible for reimbursement for the cost of an automobile rider to their existing insurance policy. To be eligible for the reimbursement, the employee must demonstrate the following:

  • Office Visits (other than Preventive Care Services) This plan covers office and clinic visits to diagnose or treat a sickness or injury. Office visit copayments differ depending on the type of provider you see. This plan covers physician visits in your home if you have an injury or illness that: • confines you to your home; or • requires special transportation; and • because of this injury or illness, you are physically unable to travel to the provider’s

  • Utilization of Sick Leave with Pay Employees who have earned sick leave credits shall be eligible for sick leave for any period of absence from employment due to any of the following reasons: • illness; • bodily injury; • disability resulting from pregnancy; • necessity for medical or dental care; • if the employee is a victim of domestic violence, harassment, sexual assault, or stalking; or the parent or guardian of a minor child or dependent who is a victim of domestic violence, harassment, sexual assault or stalking, pursuant to ORS 659A.270 through 659A.290; • attendance at an employee assistance program; • exposure to contagious disease; • for the emergency repair of personal assistive devices which are medically necessary for the employee to perform assigned duties; • attendance upon members of the employee’s or the employee’s spouse’s immediate family, or the equivalent of each for domestic partners, (parent, wife, husband, children, brother, sister, grandmother, grandfather, grandchild, or another member of the immediate household) where the employee’s presence is required because of illness or death. • parental leave The employee has the duty to insure that they make other arrangements, within a reasonable period of time, for the attendance upon children or other persons in the employee’s care. Certification of an attending physician or practitioner may be required by the Agency to support the employee’s claim for sick leave if the employee is absent in excess of seven (7) days, or if the Agency has evidence that the employee is abusing sick leave privileges. The Agency may also require such certificate from an employee to determine whether the employee should be allowed to return to work where the Agency has reason to believe that the employee’s return to work would be a health hazard to either the employee or to others. (See Section 9 for FMLA & OFLA.)

  • Restricted Use By Outsourcers / Facilities Management, Service Bureaus or Other Third Parties Outsourcers, facilities management or service bureaus retained by Licensee shall have the right to use the Product to maintain Licensee’s business operations, including data processing, for the time period that they are engaged in such activities, provided that: 1) Licensee gives notice to Contractor of such party, site of intended use of the Product, and means of access; and 2) such party has executed, or agrees to execute, the Product manufacturer’s standard nondisclosure or restricted use agreement which executed agreement shall be accepted by the Contractor (“Non-Disclosure Agreement”); and 3) if such party is engaged in the business of facility management, outsourcing, service bureau or other services, such third party will maintain a logical or physical partition within its computer system so as to restrict use and access to the program to that portion solely dedicated to beneficial use for Licensee. In no event shall Licensee assume any liability for third party’s compliance with the terms of the Non-Disclosure Agreement, nor shall the Non-Disclosure Agreement create or impose any liabilities on the State or Licensee. Any third party with whom a Licensee has a relationship for a state function or business operation, shall have the temporary right to use Product (e.g., JAVA Applets), provided that such use shall be limited to the time period during which the third party is using the Product for the function or business activity.

  • Meal Reimbursement 1. If an employee is required to work one and one-half (1-1/2) hours before or beyond his/her normal working day or on overtime for emergency purposes or for extended work periods of five (5) or more hours in length on a day that is not the employee’s regular work day, and the employee is not exercising flexible work hours, the employee shall be reimbursed for the actual cost of a meal/food items not to exceed $18.00, plus tip (not to exceed 15%) and applicable taxes. Reimbursement is contingent upon the employee providing receipts.

  • Business Expense Reimbursements During the Term, the Company shall promptly reimburse Executive for Executive’s reasonable and necessary business expenses in accordance with the Company’s then-prevailing policies and procedures for expense reimbursement (which shall include appropriate itemization and substantiation of expenses incurred).

  • Workplace Safety Insurance Benefits (WSIB) Top Up Benefits If the employee is in a class of employees that, on August 31, 2012, was entitled to use unused sick leave credits for the purpose of topping up benefits received under the Workplace Safety and Insurance Act, 1997;

  • Compensation; Reimbursement of Expenses The Guarantor agrees:

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