Common use of Procedures, Communications and Other Administrative Duties Clause in Contracts

Procedures, Communications and Other Administrative Duties. 1. OhioHealthy shall require Payor to establish a system of Beneficiary identification and procedures for verification by Practitioner (through written or telephone request) of Beneficiary eligibility to receive Covered Services and whether certain services to be rendered to a Beneficiary are Covered Services, which system and procedures shall be communicated to Practitioner. Beneficiary identification cards and such other mechanisms or procedures instituted by OhioHealthy or a Payor do not guarantee eligibility and Beneficiary eligibility determinations are not a guarantee of participation or coverage or payment, both participation and coverage must be determined in accordance with the terms of applicable Program Requirements.