Resolution and Notification Sample Clauses

Resolution and Notification. Basic rule. The Contractor must dispose of each grievance, resolve each appeal, and provide notice, as expeditiously as the member's health condition requires, within the timeframes established in §9.7.1 below.
Sample 1
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Resolution and Notification. 1. The Health Plan shall follow Agency guidelines in resolving grievances and appeals as expeditiously as possible, observing required timeframes and taking into account the enrollee’s health condition.
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Resolution and Notification. 2.5.5.1 The Contractor shall review each grievance and send a notice of resolution to the enrollee no later than ninety (90) calendar days from the date the Contractor receives the grievance.
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Resolution and Notification. CONTRACTOR shall resolve each appeal and provide notice to enrollee, as expeditiously as the enrollee's health condition requires, within the ADMINISTRATION's established timeframes, which may not exceed forty-five (45) days from the day the CONTRACTOR received the appeal.
Sample 1
Resolution and Notification. The contractor must resolve each appeal, and provide notice, as expeditiously as the enrollee’s health condition requires, within 45 days from the day the contractor receives the appeal.
Sample 1
Resolution and Notification. INSURER shall resolve each expedited appeal and provide notice, as expeditiously as the enrollee’s health condition requires, and within the ADMINISTRATION established timeframes, which may never exceed three (3) working days after the INSURER received the appeal.
Sample 1
Resolution and Notification. Grievances and Appeals (42 CFR §438.408).
Sample 1
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Resolution and Notification. Basic Rule: The CCN must dispose of a grievance and provide notice, as expeditiously as the member’s health condition requires, within the timeframes established in § 9.5.3.1 below.
Sample 1
Resolution and Notification. The contractor’s internal grievance procedure may use the timeframes provided in s. 641.511, F.S. as guidelines, unless a shorter time period is otherwise specified in this part. Standard disposition of a grievance must not exceed 90 days from the date the contractor receives the grievance, unless the enrollee requests the extension or the contractor requires additional information and the delay will not prejudice the enrollee’s interest. The extension should not exceed 14 calendar days and the contractor must provide the enrollee written notice of the reason it is requesting a delay. The contractor’s appeal process must provide for a timeframe that is no longer than 45 days from the date the appeal is received by the contractor through resolution. An extension of up to 14 days for both standard and expedited appeals, may be permitted for the same reasons as is permitted for resolution of standard grievances and as detailed in 42 CFR 438.408. The contractor must provide a method for expedited resolution of appeals as expeditiously as required by the enrollee’s condition but in any event, resolution should not exceed 3 working days after receipt of the request for appeal. If the contractor denies a request for an expedited review, it should provide for prompt oral notice of the denial to the enrollee, followed by written notice within 2 calendar days. The contractor must also provide for a transfer of the appeal to the timeframe for standard resolution of the appeal. The contractor must provide written notice of disposition of all appeals. It is recommended that the contractor provide reasonable efforts for oral notice of disposition of expedited appeals. The written notice must contain the results of the resolution process and the date it was completed. If an appeal is not resolved wholly in favor of an enrollee, the written notice must set out the enrollee’s right to request a fair hearing and the process required to make the request and the right to receive benefits while the fair hearing is pending and how to make that request. The notice should also make the enrollee aware that he or she may be held liable for the cost of those benefits if the fair hearing decision upholds the contractor’s action.
Sample 1

Related to Resolution and Notification

  • Required Notifications Each Grantor shall promptly notify the Administrative Agent, in writing, of: (i) any Lien (other than Permitted Liens) on any of the Collateral which would adversely affect the ability of the Administrative Agent to exercise any of its remedies hereunder and (ii) the occurrence of any other event which could reasonably be expected to have a material impairment on the aggregate value of the Collateral or on the security interests created hereby.

  • Resolution of Claims The Company acknowledges that a settlement or other disposition short of final judgment may be successful on the merits or otherwise for purposes of Section 8(a)(i) if it permits a party to avoid expense, delay, distraction, disruption and uncertainty. In the event that any Claim relating to an Indemnifiable Event to which Indemnitee is a party is resolved in any manner other than by adverse judgment against Indemnitee (including, without limitation, settlement of such action, claim or proceeding with our without payment of money or other consideration) it shall be presumed that Indemnitee has been successful on the merits or otherwise for purposes of Section 8(a)(i). The Company shall have the burden of proof to overcome this presumption.

  • Notification of litigation The Borrower will provide the Agent with details of any legal or administrative action involving the Borrower, any Security Party, the Approved Manager, any Ship or the Earnings or the Insurances of any Ship as soon as such action is instituted or it becomes apparent to the Borrower that it is likely to be instituted, unless it is clear that the legal or administrative action cannot be considered material in the context of any Finance Document.

  • Procedures for Voting and Consents The rules and procedures for calling and conducting any meeting of the holders of Designated Preferred Stock (including, without limitation, the fixing of a record date in connection therewith), the solicitation and use of proxies at such a meeting, the obtaining of written consents and any other aspect or matter with regard to such a meeting or such consents shall be governed by any rules of the Board of Directors or any duly authorized committee of the Board of Directors, in its discretion, may adopt from time to time, which rules and procedures shall conform to the requirements of the Charter, the Bylaws, and applicable law and the rules of any national securities exchange or other trading facility on which Designated Preferred Stock is listed or traded at the time.

  • Procedures for Notification and Defense of Claim (a) Indemnitee shall notify the Company in writing of any matter with respect to which Indemnitee intends to seek indemnification or advancement of Expenses as soon as reasonably practicable following the receipt by Indemnitee of notice thereof. The written notification to the Company shall include, in reasonable detail, a description of the nature of the Proceeding and the facts underlying the Proceeding. The failure by Indemnitee to notify the Company will not relieve the Company from any liability which it may have to Indemnitee hereunder or otherwise than under this Agreement, and any delay in so notifying the Company shall not constitute a waiver by Indemnitee of any rights, except to the extent that such failure or delay materially prejudices the Company.

  • Governing Law; Resolution of Disputes This Agreement and the rights and obligations hereunder shall be governed by and construed in accordance with the laws of the State of Wisconsin. Any dispute arising out of this Agreement shall, at the Executive’s election, be determined by arbitration under the rules of the American Arbitration Association then in effect (in which case both parties shall be bound by the arbitration award) or by litigation. Whether the dispute is to be settled by arbitration or litigation, the venue for the arbitration or litigation shall be Milwaukee, Wisconsin or, at the Executive’s election, if the Executive is not then residing or working in the Milwaukee, Wisconsin metropolitan area, in the judicial district encompassing the city in which the Executive resides; provided, that, if the Executive is not then residing in the United States, the election of the Executive with respect to such venue shall be either Milwaukee, Wisconsin or in the judicial district encompassing that city in the United States among the thirty cities having the largest population (as determined by the most recent United States Census data available at the Termination Date) which is closest to the Executive’s residence. The parties consent to personal jurisdiction in each trial court in the selected venue having subject matter jurisdiction notwithstanding their residence or situs, and each party irrevocably consents to service of process in the manner provided hereunder for the giving of notices.

  • Dispute Resolution and Governing Law The Parties agree that all disputes arising pursuant to this Agreement shall be resolved by way of negotiations and discussions and with a view to an amicable settlement and mutual benefit of both Parties. Any negotiation for the settlement of dispute shall be governed by the laws of the country where such dispute arises.

  • Certain Notifications At all times from the date hereof to the Closing Date, each party shall promptly notify the others in writing of the occurrence of any event that will or may result in the failure to satisfy any of the conditions specified in Article 8 hereof.

  • Dispute Resolution and Jurisdiction Any controversy or claim arising out of or relating to this Agreement, or the breach thereof shall be settled by arbitration in accordance with the rules of the American Arbitration Association and judgment upon the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof, except that arbitration shall not apply to (1) controversies and claims of less than $5,000, nor to (2) claims seeking to collect liquidated amounts, such as the Tuition promised by the student. Any legal dispute (not resolved in arbitration) shall be governed by the laws of the state of California, and that Santa Xxxxxxx courts are the exclusive venue.

  • Consents, Declaration and Directions Except as provided in Section 2.14.5, the Company, the Trustee and any Agent shall treat a person as the Holder of such principal amount of outstanding Securities of such Series represented by a Global Security as shall be specified in a written statement of the Depositary with respect to such Global Security, for purposes of obtaining any consents, declarations, waivers or directions required to be given by the Holders pursuant to this Indenture.

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