QDP definition
Examples of QDP in a sentence
Contractor shall comply with applicable laws, rules and regulations relating to the provision of Specialized Health Care Services to any individual enrolled in Contractor’s QDP in the Covered California for the Individual Market who is determined by Covered California to be an eligible American Indian or Alaskan Native as defined in § 4(d) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. § 450b(d).
In no event shall Covered California be liable to Contractor with respect to any interest or other charges relating to premium funds received by Covered California that are not yet disbursed by Covered California to QDP Issuers.
Unless otherwise agreed to by Covered California, Contractor shall continue to provide information describing all Participating Providers in its QDP networks in a format prescribed by Covered California on a monthly basis to support Covered California’s centralized provider directory containing every QDP’s network providers, this includes testing, implementation and continued evaluation.
All QDP Issuers shall utilize the Symphony Provider Directory to populate, maintain, and continually update, provider network data, including demographic, licensure, and other relevant information with respect to all their QDPs, as well as to provide information regarding the terms and restrictions governing such Providers’ participation in the QDPs offered by Contractor through Covered California.
Contractor shall be solely responsible for compensating Agents who sell Contractor’s QDP through the individual market of Covered California.
Covered California shall transmit information required for Contractor to enroll the applicant, and Contractor shall enroll applicant within five (5) business days of receipt of verification of eligibility and selection of Contractor’s QDP.
Contractor shall staff their call center with highly trained individuals to provide detailed benefit information, answer Enrollee questions about QDP benefits and coverage, and to resolve claim and benefit issues.
The timely and accurate submission of Contractor’s QDP filings and documents to Covered California for upload into CalHEERS is critical to the successful launch of each Renewal and Open Enrollment Period.
Contractor may appeal the decertification of its QDP that will result in connection with the termination of this Agreement and such appeal shall be conducted pursuant to the Covered California’s process and in accordance with applicable laws, rules and regulations.
In the event that a Covered California Enrollee requires immediate care, the QDP Issuer will work closely with Covered California to implement any eligibility or enrollment changes as soon as reasonably possible.