Provider Notifications Sample Clauses
The Provider Notifications clause establishes the requirements and procedures for how and when a service provider must inform the client or other relevant parties about important events or changes. Typically, this clause outlines the types of information that must be communicated—such as service disruptions, changes in key personnel, or compliance issues—and specifies the acceptable methods and timelines for delivering such notifications, like via email or written letter within a set number of days. Its core practical function is to ensure timely and effective communication, thereby minimizing misunderstandings and enabling prompt responses to issues as they arise.
Provider Notifications. A. The Contractor shall inform providers and subcontractors, at the time they enter into a contract, about:
1) Beneficiary grievance, appeal, and fair hearing procedures and timeframes as specified in 42 CFR 438.400 through 42 CFR 438.424.
2) The beneficiary’s right to file grievances and appeals and the requirements and timeframes for filing.
3) The availability of assistance to the beneficiary with filing grievances and appeals.
4) The beneficiary’s right to request a State fair hearing after the Contractor has made a determination on an beneficiary's appeal, which is adverse to the beneficiary.
5) The beneficiary’s right to request continuation of benefits that the Contractor seeks to reduce or terminate during an appeal or state fair hearing filing, if filed within the allowable timeframes, although the beneficiary may be liable for the cost of any continued benefits while the appeal or state fair hearing is pending if the final decision is adverse to the beneficiary.
Provider Notifications. A. The Contractor shall inform providers and subcontractors, at the time they enter into a contract, about:
1) Beneficiary grievance, appeal, and State Hearing procedures and timeframes as specified in 42 C.F.R. 438.400 through 42 C.F.R. 438.424.
2) The beneficiary’s right to file grievances and appeals and the requirements and timeframes for filing.
3) The availability of assistance to the beneficiary with filing grievances and appeals.
4) The beneficiary’s right to request a State Hearing after the Contractor has made a determination on a beneficiary's appeal, which is adverse to the beneficiary.
5) The beneficiary’s right to request continuation of benefits that the Contractor seeks to reduce or terminate during an appeal or State Hearing filing, if filed within the allowable timeframes, although the beneficiary may be liable for the cost of any continued benefits while the appeal or State Hearing is pending if the final decision is adverse to the beneficiary.
Provider Notifications. The State and the Union agree that it is the parents’ responsibility to inform the provider about any changes regarding the voucher status, including redetermination of CCS eligibility. However, the State agrees to hold a provider harmless from any obligation to reimburse the State for CCS monies received resulting from a provider caring for a child whose care has been authorized by the State, and the child’s parent is later found to have fraudulently received eligibility in the CCS program. This provision shall not apply in instances of proven collusion by a provider in an act or parental fraud.
Provider Notifications. A. The Contractor shall inform contracted providers, at the time they enter into a contract, about:
1) Member grievance, appeal, and State Hearing procedures and timeframes as specified in 42 C.F.R. sections 438.400 - 438.424.
2) The member’s right to file grievances and appeals, orally or in writing, and the requirements and timeframes for filing.
3) The availability of assistance to the member with filing grievances and appeals.
4) The member’s right to give written consent to allow a provider, acting on behalf of the member, to file a grievance or appeal.
5) The member’s right to request a State Hearing after the Contractor has made a determination on a member's appeal, which is adverse to the member.
6) The member’s right to request continuation of benefits that the Contractor seeks to reduce or terminate during an appeal or State Hearing filing, if filed within the allowable timeframes.
7) Any state-determined provider’s appeal rights to challenge the failure of the Contractor to cover a service.