Proof of WSIA Coverage Unless the HSP puts into effect and maintains Employers Liability and Voluntary Compensation as set out above, the HSP will provide the Funder with a valid Workplace Safety and Insurance Act, 1997 (“WSIA”) Clearance Certificate and any renewal replacements, and will pay all amounts required to be paid to maintain a valid WSIA Clearance Certificate throughout the term of this Agreement.
Proof At the investigation, did the `judge' obtain substantial evidence or proof that the employee was guilty as charged?"
Proof of Loss For Covered Services provided by Contracting Providers, Preferred and Participating Dentists, Contracting Vision Providers, and Contracting Pharmacies, Members are not required to submit claims in order to obtain benefits. For Covered Services provided by Non-Contracting Providers, Non-Participating Dentists, Non-Contracting Vision Providers, and Non-Contracting Pharmacies, Members must furnish written proof of loss, or have the provider submit proof of loss, to CareFirst BlueChoice within one (1) year after the date of the loss. The Member is also responsible for providing information requested by CareFirst BlueChoice including, but not limited to, medical records. Failure to furnish proof within the time required shall not invalidate or reduce any claim if it was not reasonably possible to give proof within the required time, provided proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one (1) year from the time proof is otherwise required. CareFirst BlueChoice will honor claims submitted for Covered Services, Covered Dental Services, or Covered Vision Services by any agency of the federal, state, or local government that has the statutory authority to submit claims beyond the time limits established under this In-Network Agreement. These claims must be submitted to CareFirst BlueChoice before the filing deadline established by the applicable statute on claims forms that provide all of the information CareFirst BlueChoice deems necessary to process the claims. CareFirst BlueChoice provides forms for this purpose.
Community Based Adult Intensive Service (AIS) and Child and Family Intensive Treatment (CFIT) – AIS/CFIT programs offer services primarily based in the home and community for qualifying adults and children with moderate- to-severe mental health conditions. These programs consist at a minimum of ongoing emergency/crisis evaluations, psychiatric assessment, medication evaluation and management, case management, psychiatric nursing services, and individual, group, and family therapy. This plan covers individual psychotherapy, group psychotherapy, and family therapy when rendered by: • Psychiatrists; • Licensed Clinical Psychologists; • Licensed Independent Clinical Social Workers; • Advance Practice Registered Nurses (Clinical Nurse Specialists/Nurse Practitioners- Behavioral Health); • Licensed Mental Health Counselors; and • Licensed Marriage and Family Therapists. This plan covers psychological testing as a behavioral health benefit when rendered by: • neuropsychologists; • psychologists; or • pediatric neurodevelopmental specialists. This plan covers neuropsychological testing as described in the Tests, Labs and Imaging section.
Proofs The Ceding Company will promptly provide the Reinsurer with proper claim proofs, including a copy of the proof of payment by the Ceding Company, and a copy of the insured's death certificate. In addition, for contestable claims, the Ceding Company will send to the Reinsurer a copy of all papers in connection with the claim.
