Services for New Members Sample Clauses

Services for New Members. The PH-MCO must make available the full scope of benefits to which a Member is entitled from the effective Enrollment date provided by the Department. The PH-MCO must make a best effort to conduct an initial screening of each member’s needs, within 90 days of the effective date of enrollment for all new members, including subsequent attempts if the initial attempt to contact the member is unsuccessful. The PH-MCO must share with DHS or any other MCO serving the member the results of any identification and assessment of that member’s needs to prevent duplication of those activities. The PH-MCO will collaborate with the Department to develop, adopt and disseminate a resource and referral tool. The PH-MCO must use pertinent demographic information about the Recipient, i.e., Special Needs data collected through the EAP or directly indicated to the PH-MCO by the Recipient after Enrollment, upon the new Member's effective Enrollment date in the PH-MCO. If a Special Need is indicated, the PH-MCO must place a Special Needs indicator on the Member's record and must outreach to that Member to identify their Special Need or circumstance. The PH- MCO must assure that the Member’s needs are adequately addressed including the assignment of a Special Needs or Care Management case manager as appropriate. The PH-MCO must comply with access standards as required in Exhibit AAA, as applicable, Provider Network Composition/Service Access and follow the appointment standards described in Exhibit AAA, as applicable, when an appointment is requested by a Member.
Sample 1Sample 2Sample 3See All (12)
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Services for New Members. Contractor agrees to make available the full scope of benefits to which a member is entitled immediately upon his or her enrollment.
Sample 1Sample 2Sample 3See All (11)
Services for New Members. ‌ The PH-MCO must make available the full scope of benefits to which a Member is entitled from the effective Enrollment date provided by the Department. The PH-MCO must ensure that pertinent demographic information about the Recipient, i.e., Special Needs data collected through the EAP or directly indicated to the PH-MCO by the Recipient after Enrollment, will be used by the PH-MCO upon the new Member's effective Enrollment date in the PH-MCO. If a Special Need is indicated, the PH-MCO is required to place a Special Needs indicator on the Member's record and must outreach to that Member to identify their Special Need or circumstance. The PH- MCO must assure that the Member’s needs are adequately addressed. The PH-MCO must comply with access standards as required in Exhibit AAA(1), AAA(2), or AAA(3), as applicable, of this Agreement, Provider Network Composition/Service Access and follow the appointment standards described in Exhibit AAA(1), AAA(2), or AAA(3), as applicable, when an appointment is requested by a Member.
Sample 1Sample 2Sample 3See All (10)
Services for New Members. The Contractor must make available the full scope of benefits to which a Member is entitled from the effective enrollment date provided by the Department. Detailed descriptions of those services can be found in the HealthChoices Proposers' Library in the materials describing the MA FFS Program for those services. The Contractor must ensure that pertinent demographic information about the MA Consumer, i.e., Special Needs data collected through the IEAP or directly indicated to the Contractor by the MA Consumer after enrollment, will be used by the Contractor upon the new Member's effective enrollment date in the PH-MCO. If a Special Need is indicated, the Contractor is required to place a Special Needs indicator on the Member's record and must outreach to that Member to identify their Special Need or circumstance. For any Member with a Special Needs indicator, the Contractor must arrange for a health needs assessment within forty-five (45) days; provide results of the same to the assigned PCP; and track and follow-up outcomes to assure the Member's needs are adequately addressed. The Contractor must comply with access standards as required in Section V.S of this Agreement, Provider Network/Services Access and follow the appointment standards described in Section V.S.12 of this Agreement, Appointment Standards, when an appointment is requested by a Member.
Sample 1

Related to Services for New Members

  • Admission of New Members The Company may admit new Members (or transferees of any interests of existing Members) into the Company by the unanimous vote or consent of the Members. As a condition to the admission of a new Member, such Member shall execute and acknowledge such instruments, in form and substance satisfactory to the Company, as the Company may deem necessary or desirable to effectuate such admission and to confirm the agreement of such Member to be bound by all of the terms, covenants and conditions of this Agreement, as the same may have been amended. Such new Member shall pay all reasonable expenses in connection with such admission, including without limitation, reasonable attorneys’ fees and the cost of the preparation, filing or publication of any amendment to this Agreement or the Articles of Organization, which the Company may deem necessary or desirable in connection with such admission. No new Member shall be entitled to any retroactive allocation of income, losses, or expense deductions of the Company. The Company may make pro rata allocations of income, losses or expense deductions to a new Member for that portion of the tax year in which the Member was admitted in accordance with Section 706(d) of the Internal Revenue Code and regulations thereunder. In no event shall a new Member be admitted to the Company if such admission would be in violation of applicable Federal or State securities laws or would adversely affect the treatment of the Company as a partnership for income tax purposes. (Check if Applicable)

  • Objection Right for New Sub-processors Client may reasonably object to Data Processor’s use of a new Sub-processor for reasons related to the GDPR by notifying Data Processor promptly in writing within three (3) business days after receipt of Data Processor’s notice in accordance with the mechanism set out in Section 5.2 and such written objection shall include the reasons related to the GDPR for objecting to Data Processor’s use of such new Sub-processor. Failure to object to such new Sub-processor in writing within three (3) business days following Data Processor’s notice shall be deemed as acceptance of the new Sub-Processor. In the event Client reasonably objects to a new Sub-processor, as permitted in the preceding sentences, Data Processor will use reasonable efforts to make available to Client a change in the Services or recommend a commercially reasonable change to Client’s use of the Services to avoid Processing of Personal Data by the objected-to new Sub-processor without unreasonably burdening the Client. If Data Processor is unable to make available such change within a reasonable period of time, which shall not exceed thirty (30) days, Client may, as a sole remedy, terminate the applicable Agreement and this DPA with respect only to those Services which cannot be provided by Data Processor without the use of the objected- to new Sub-processor by providing written notice to Data Processor provided that all amounts due under the Agreement before the termination date with respect to the Processing at issue shall be duly paid to Data Processor. Until a decision is made regarding the new Sub-processor, Data Processor may temporarily suspend the Processing of the affected Personal Data. Client will have no further claims against Data Processor due to the termination of the Agreement (including, without limitation, requesting refunds) and/or the DPA in the situation described in this paragraph.

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