Transactions Standards Sample Clauses

Transactions Standards. The HIPAA Rules provide for certain Transactions Standards for transfer of data between trading partners. While certain of the standards may or may not be adopted by Plan (e.g., for eligibility), ESI will be prepared to accept the following in accordance with 45 C.F.R. Part 162.1502: ASC X12N 834 – Benefit Enrollment and Maintenance. In addition, to the extent applicable, ESI shall comply with other applicable transactions standards for claims processing functions between ESI and provider pharmacies. Each party hereby agrees that it shall not change any definition, data condition or use of a data element or segment in a standard, add any data elements or segment to the maximum defined data set, use any code or data elements that are either marked “not used” in the standard’s implementation specification or are not in the implementation specification, or change the meaning or intent of the implementation specification.
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Transactions Standards. ‌ Selected ASC X12N standards include, as applicable, all data dictionaries, segment dictionaries and transmission controls referenced in those standards, but include only the Transaction Sets listed in the Documents section below. Documents Trading Partner will send to HP the following documents: Transaction Set No. Document Name/Description Version Release Transactions sent by Trading Partner 837 Health Care Claim: Institutional 4010A1 (Yes/ No) 837 Health Care Claim: Professional 4010A1 837 Health Care Claim: Dental 4010A1 270 Health Care Eligibility Benefit Inquiry 4010A1 276 Health Care Claim Status Request 4010A1 834 Benefit Enrollment and Maintenance 4010A1 278 Prior Authorization 4010A1 NCPDP Pharmacy 5.1 Number of Providers for which you xxxx Estimated Claim Volume per Month Expected Frequency of Claim Submission HP will be sending the following documents to the Trading Partner: Transaction Set No. Document Name/Description Version Release Transactions received by Trading Partner (Yes/No) 820 Payroll Deducted and Premium Payment 4010A1 834 Benefit Enrollment and Maintenance 4010A1 835 Health Care Claim Payment/Advice 4010A1 271 Health Care Eligibility Benefit Response 4010A1 277 Health Care Claim Status Response 4010A1 278 Prior Authorization Response 4010A1 NCPDP Pharmacy 5.1 997 Functional Acknowledgment 4010A1 Yes Guidelines HIPAA Health Insurance Portability and Accountability Act In the event of any conflict, HIPAA standards and Implementation Guidelines shall control.
Sample 1
Transactions Standards. To the extent applicable, ESI will comply with the applicable transactions standards for claims processing functions between ESI and provider pharmacies. The parties each hereby agree that it will not change any definition, data condition or use of a data element or segment in a standard, add any data elements or segment to the maximum defined data set, use any code or data elements that are either marked “not used” in the standard’s implementation specification or are not in the implementation specification, or change the meaning or intent of the implementation specification.
Sample 1
Transactions Standards. The parties agree to electronically exchange Data to the maximum extent practical. Parties agree to transmit said Data using the form and method outlined in applicable EDI industry standard publications or using mutually acceptable alternatives. Agreement Number 99006677 Exhibit D Sample Schedule
Sample 1
Transactions Standards. The HIPAA Rules provide for certain Transactions Standards for transfer of data between trading partners. While certain of the standards may or may not be adopted by Plan (e.g., for eligibility), ESI will be prepared to accept the following in accordance with 45 C.F.R. Part 162.1502: ASC X12N 834 – Benefit Enrollment and Maintenance. In addition, to the extent applicable, ESI shall comply with other applicable Transactions Standards for claims processing functions between ESI and provider pharmacies and shall conduct any such transaction as a “standard transaction” as that term is defined under 45 CFR Part 162. ESI shall require any agent or Subcontractor to comply with all applicable requirements of 45 CFR Part 162. Each party hereby agrees that it shall not change any definition, data condition or use of a data element or segment in a standard, add any data elements or segment to the maximum defined data set, use any code or data elements that are either marked “not used” in the standard’s implementation specification or are not in the implementation specification, or change the meaning or intent of the implementation specification.
Sample 1

Related to Transactions Standards

  • OMB Standards Unless specified otherwise within this agreement, the Subrecipient shall procure all materials, property, or services in accordance with the requirements of 24 CFR 84.40−48.

  • Applicable Standards The requirements and guidelines of NERC, the Applicable Regional Entity, and the Control Area in which the Customer Facility is electrically located; the PJM Manuals; and Applicable Technical Requirements and Standards.

  • Procurement Standards For projects being managed by the Local Government and on the State highway system or that include state funding, the Local Government must obtain approval from the State for its proposed procurement procedure for the selection of a professional services provider, a contractor for a construction or maintenance project, or a materials provider.

  • Content Standards You agree that you will not upload or provide content or otherwise post, transmit, distribute, or disseminate through the Zelle® Payment Service any material that: (1) is false, misleading, unlawful, obscene, indecent, lewd, pornographic, defamatory, libelous, threatening, harassing, hateful, abusive, or inflammatory; (2) encourages conduct that would be considered a criminal offense or gives rise to civil liability; (3) breaches or infringes any duty toward or rights of any person or entity, including rights of publicity, privacy or intellectual property; (4) contains corrupted data or any other harmful, disruptive, or destructive files; (5) advertises products or services competitive with Zelle®, as determined by Zelle® in its sole discretion; or (6) in Zelle®’s or our sole judgment, is objectionable, restricts or inhibits any person or entity from using or enjoying any portion of the Zelle® Payment Service, or which may expose us, Zelle® or our respective affiliates or customers to harm or liability of any nature.

  • Human and Financial Resources to Implement Safeguards Requirements 10. The Borrower shall make available or cause the State and the DISCOMs to make available necessary budgetary and human resources to fully implement the EMP, the RP and any IPP.

  • Licensing Standards The Contractor, its employees and subcontractors shall comply with all applicable licensing standards, certification standards, accrediting standards and any other laws, rules, or regulations governing services to be provided by the Contractor pursuant to this Contract. The State will not pay the Contractor for any services performed when the Contractor, its employees or subcontractors are not in compliance with such applicable standards, laws, rules, or regulations. If any license, certification or accreditation expires or is revoked, or any disciplinary action is taken against an applicable license, certification, or accreditation, the Contractor shall notify the State immediately and the State, at its option, may immediately terminate this Contract.

  • General Standards An Assistant Professor will be competent to teach in a particular field, will be current in the literature of that field, and will seek to meet student needs in both the classroom and in non-classroom environments. However, an Assistant may be a junior member of the academic community, with little professional and/or teaching experience. Furthermore, an Assistant may have little experience in curriculum development, committee work, governance, professional and/or community service, etc. In short, an Assistant Professor generally will be new to tenure-track college teaching. For eligibility for promotion from Assistant to Associate Professor, the candidate must have served a minimum of four (4) years at the rank of Assistant Professor, and must show evidence that he/she has grown professionally and consistently has sought to meet student needs, in both the classroom and in non-classroom environments. A successful candidate for the rank of Associate Professor will have remained current in the field, and will have improved his/her teaching in some demonstrable way. He/she also will have demonstrated professional growth in one or more of the following ways: completion of additional appropriate course work (if applicable), attendance at professional conferences, service on campus and/or District committees, professional and/or community service, or, the production of some creative work. Evidence of professional growth will be drawn from a careful analysis of student evaluations and peer evaluations over a period of time, and from a critical reading of materials submitted by the candidate. For promotion from Associate to Professor, the candidate must have served a minimum of four (4) years at the rank of Associate Professor, and must show evidence that he/she has grown professionally to a point where he/she has mastered both a particular field of knowledge and the teaching of that knowledge. A successful candidate must show evidence that he/she consistently has sought to meet student needs, in both the classroom and non-classroom environments. A Professor should be a senior member of the faculty, one who has such substantial experience, knowledge, and skill that he/she could mentor junior faculty in his/her area of expertise. A Professor will have demonstrated all the same kinds of achievements and attributes necessary for promotion to the Associate Professor rank, but in addition will demonstrate that he/she is a leader in some appropriate sense. Evidence of professional growth and leadership will be drawn from a careful analysis of student evaluations and peer evaluations over a period of time, and from a critical reading of materials submitted by the candidate.

  • ETHICAL STANDARDS a. Distributor and each of its sub-distributors will comply with the United States Foreign Corrupt Practices Act and without derogating from the generality of the foregoing, will not have its directors, officers or employees, directly or indirectly, offer, promise or pay any bribes or other improper payments for the purposes of promoting and/or selling Products to any individual, corporation, government official or agency or other entity. No gift, benefit or contribution in any way related to MEC or the promotion and/or sale of Products will be made to political or public officials or candidates for public office or to political organizations, regardless of whether such contributions are permitted by local laws.

  • EMPLOYMENT STANDARDS There are no material complaints against the Corporation or the Subsidiaries before any employment standards branch or tribunal or human rights tribunal, nor any complaints or any occurrence which would reasonably be expected to lead to a complaint under any human rights legislation or employment standards legislation that would be material to the Corporation. There are no outstanding decisions or settlements or pending settlements under applicable employment standards legislation which place any material obligation upon the Corporation or the Subsidiaries to do or refrain from doing any act. The Corporation and Subsidiaries are currently in material compliance with all workers’ compensation, occupational health and safety and similar legislation, including payment in full of all amounts owing thereunder, and there are no pending claims or outstanding orders of a material nature against either of them under applicable workers’ compensation legislation, occupational health and safety or similar legislation nor has any event occurred which may give rise to any such material claim.

  • OFFICE OF MANAGEMENT AND BUDGET (OMB) AUDIT REQUIREMENTS The parties shall comply with the requirements of the Single Audit Act of 1984, P.L. 98-502, ensuring that the single audit report includes the coverage stipulated in 2 CFR 200.

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