Private Insurance. If Grantee is a private entity, or if any contractors, subcontractors, or subgrantees used to carry out the Project are private entities, Grantee and any private contractors, subcontractors or subgrantees must obtain and maintain insurance covering Agency in the types and amounts indicated in Exhibit C.
Private Insurance. If you have insurance or health care coverage, our billing service will bill your insurance company or health carrier for you. By entering into this contract, you authorize us to release health information to our billing service, and for our billing service to release health information to your insurance company or health carrier for the purpose of processing your claims. Our billing service may bill your insurance company or health carrier for the following services related to your care including, but not limited to: Initial visit; lab work; OB global fee including delivery; intrapartum care; supplies; IV therapy; newborn exams & newborn screens; postpartum home visits. (If global fee is not applicable, individual visits are billed.) If your insurance denies your claims, you are responsible for paying us the entire fee. If, upon verification of benefits, your insurance company is likely to pay, we may agree to only collect the deposit, your deductibles for you and your baby, and approximate coinsurance amounts (patient responsibility or “PR”) up front, rather than collecting the entire fee. If your insurance company pays, and we find that we have overcharged you, we will refund you accordingly. If the insurance assigns PR that exceeds what we have collected from you, we will bill you for the deficit. If you have insurance and you’ve paid the entire fee in advance, and if your insurance company pays us directly, we will send you a refund. Your refund cannot exceed the amount you prepaid less your non-refundable deposit. Your refund amount will be affected by your assigned PR amounts and any deductibles (for you and your baby) applied to our claims independently of reimbursement amounts we receive. If your insurance company reimburses you directly, you agree to cooperate with our billing service. Our billing service will determine how much of the reimbursement should be sent to us, and how much, if any, is yours to keep. In this situation, you agree to reimburse us immediately. Any unpaid balance remaining 30 days after the insurance reimbursement was sent is considered delinquent and is subject to a 1.5% monthly interest charge. Client agrees to pay a non-refundable deposit of $200.00 which covers adminstrative and insurance billing services. Vivante pays an average of $200-$250 to the billing service for each claim processed. The birth assistant fee of $400, is payable by check at 36 weeks, and is not billable to insurance. The birth assistant fee is paid...
Private Insurance. Variables identifying private insurance in general (PRIV1, PRIV2, PRIV3, PRIV96, PRIVAT1, PRIVAT2, PRIVAT96) and specific private insurance sources [such as employer/union group insurance (PRIEU1, PRIEU2, PRIEU3, PRIEU96); non-group (PRING1, PRING2, PRING3, PRING96); and other group (PRIOG1, PRIOG2, PRIOG3, PRIOG96)] were constructed. Variables indicating any private insurance coverage are available for the following time periods: at any time in Rounds 1, 2 or the 1996 portion of Round 3, at the interview dates and on December 31st. The variables for the specific sources of private coverage are only available for coverage on the interview dates and on December 31st. Note that these variables indicate coverage within a source and do not distinguish between persons who are covered on one or more than one policy within a given source. In some cases, the policyholder was unable to characterize the source of insurance (PRIDK1, PRIDK2, PRIDK3, PRIDK96). Covered persons are also identified when the policyholder is living outside the RU (PROUT1, PROUT2, PROUT3, PROUT96). An individual was considered to have private health insurance coverage if, at a minimum, that coverage provided benefits for hospital and physician services (including Medigap coverage). Sources of insurance with missing information regarding the type of coverage were assumed to contain hospital/physician coverage. Persons without private hospital/physician insurance were not counted as privately insured. Health insurance through a job or union (PRIEU1, PRIEU2, PRIEU3, PRIEU96) was initially asked about in the Employment Section of the interview and later confirmed in the Health Insurance Section. Respondents also had an opportunity to report employer and union group insurance for the first time in the Health Insurance Section, but this insurance was not linked to a specific job. All insurance reported to be through a job classified as self-employed with firm size of 1 (PRIS1, PRIS2, PRIS3, PRIS96) was initially reported in the Employment Section and verified in the Health Insurance Section. Unlike the other employment-related variables, self-employed-firm size 1 health insurance could not be reported in the Health Insurance section for the first time. The variables PRIS1, PRIS2, PRIS3, PRIS96 have been constructed to allow users to determine if the insurance should be considered employment-related. Private insurance that was not employment-related was reported in the Health Insurance section only...
Private Insurance. When the resident has private insurance that is accepted by the facility, the facility will xxxx timely the private insurance company for the services provided to the resident. By submitting the claim to the private insurer, the facility is not making any representation or warranty about the availability or extent of coverage. If coverage is denied, the resident is obligated to pay for the services provided upon receipt of the coverage denial. Further, any appeal of a private insurance coverage decision is solely the responsibility of the resident and a pending appeal will not impact the resident’s obligation to pay for the services for which coverage was denied. If the private insurance company ultimately makes payment, the facility will promptly reimburse the resident. Finally, the resident agrees to promptly pay to the facility any deductible, co-payment or co- insurance amounts due as determined by the private insurance company.
Private Insurance a) The owner’s Public Liability Insurance only gives very limited protection.
Private Insurance. Drug and Alcohol Services does not accept or bill private insurance. We can provide referrals to other community providers or you may choose to self-pay for services (see below) on a sliding fee scale.
Private Insurance. The District will not assume any portion of personal property losses 9 under Sections 15 or 16 covered by private insurance carriers.
Private Insurance. If contractor is a private entity, or if any contractors, subcontractors, or subgrantees used to carry out the Project are private entities, Grantee and any private contractors, subcontractors or subgrantees must obtain and maintain insurance covering Agency in the types and amounts indicated in Exhibit B.
Private Insurance. T) Eviction from the Caravan ( page 5 ) U) The Caravan Site
Private Insurance. Residents who are covered by a private insurance plan that does not have a contract with the Home must exhaust all available insurance coverage before seeking Medicare or Medicaid coverage. Where the insurance proceeds under the private plan are insufficient to cover the cost of care, the Resident (and/or the Resident’s Spouse, Financial Sponsor and/or Designated Representative, as applicable) will be responsible for any difference. The coverage requirements for nursing home care vary depending on the terms of the insurance policy. Questions regarding private insurance coverage should be directed to the social work staff and/or the Resident’s insurance carrier or agent. MEDICAID * Medicaid is a publicly-funded program of assistance that covers nursing home Residents who can demonstrate financial need. To qualify for Medicaid, an individual may have only limited assets. For example, in January 2022 generally no more than $16,800 (subject to annual increases).. Generally, for a resident who is receiving Medicaid, most of the Resident’s monthly income must be paid to the Home, except for a $50 monthly “personal needs allowance” and the monthly cost of retaining a private health insurance policy. The monthly income obligation, called the income contribution or NAMI (Net Available Monthly Income), is determined by the Medicaid agency. If the Resident has a spouse in the community, the spouse might be entitled to a contribution from the Resident’s monthly income. During 2022, the “community spouse” is-entitled-to a Minimum Monthly Maintenance Needs Allowance (MMMNA) of $3,435 and with respect to resources the Maximum Federal Community Spouse Resource Allowance is $137,400 and the Minimum State Community Spouse Resource Allowance is $74,820 (these figures are subject to change each calendar year); increases beyond these amounts are possible, but a Fair Hearing (conducted by the Human Resources Administration of the City of New York or appropriate County Department of Social Services) or a Family Court support proceeding may be required. The Resident’s home may be exempt for Medicaid eligibility purposes if the spouse or other specified family members reside there. A Resident or spouse who transfers cash and/or property within five (5) years of applying for Medicaid nursing home benefits can create a period of Medicaid ineligibility. Private pay Residents should apply for Medicaid about three months before their funds are depleted. A Medicaid application will requ...
