Administrative Appeals An administrative appeal is a request for us to reconsider a full or partial denial of payment for covered healthcare services for the following reasons: • the services were excluded from coverage; • we determined that you were not eligible for coverage; • you or your provider did not follow BCBSRI’s requirements; or • a limitation on an otherwise covered benefit exists. You are not required to file a complaint (as described above), before filing an administrative appeal. If you call our Customer Service Department, a Customer Service Representative will try to resolve your concern. If the issue is not resolved to your satisfaction, you may file a verbal or written administrative appeal with our Grievance and Appeals Unit. If you request an administrative appeal, you must do so within one hundred eighty (180) days of receiving a denial of payment for covered healthcare services. The Grievance and Appeals Unit will conduct a thorough review of your administrative appeal and respond within: • thirty (30) calendar days for a prospective review; and • sixty (60) calendar days for a retrospective review. The letter will provide you with information regarding our determination.
Administrative Arrangements 1. The Parties, through their respective competent authorities, shall establish administrative arrangements to implement this Agreement effectively. Such arrangements shall include the procedures necessary for the competent authorities to implement and administer this Agreement.
Administrative Costs Administrative costs will not be included in the budget neutrality agreement, but the state must separately track and report additional administrative costs that are directly attributable to the demonstration. All administrative costs must be identified on the Forms CMS-64.10 Waiver and/or 64.10P Waiver.
Administrative information IV.2.2) Time limit for receipt of tenders or requests to participate Date
Administrative Evaluation It is the intent of the SCD administration to conduct evaluations of non-priority- hire faculty as early as possible in a faculty member's employment in an SCD instructional unit. Administrative evaluation should occur before the beginning of the fifth quarter within the nine (9) out of twelve (12) quarter sequence outlined in Article 10.7.a.
Administrative data Before the mobility, it is necessary to fill in page 1 with information on the student, the Sending and the Receiving Institutions. The three parties have to agree on this section to be completed before the mobility. On page 1, most of the information related to the student, Sending and Receiving Institutions will have to be encoded in the Mobility Tool+ (for Capacity Building projects, in the EACEA Mobility Tool).
Administrative Functions Include any or a combination of: liaising with other departments on work flows and other matters; participating in interdepartmental meetings; coordinating transactions with external agencies on behalf of department; formulating and updating departmental procedures; recommending changes to Administration; compiling statistical reports on departmental activity. Administrative Levels Duties First level: As listed above. Second level: Participates in development and monitoring of departmental budget.
Administrative Civil Liability The Settling Respondent hereby agrees to the imposition of an administrative civil liability totaling $549,600 to resolve the alleged violations set forth in Section II, paragraph 4, as follows:
Administrative Duties 94 SECTION 12.2 Records.....................................................................97 SECTION 12.3 Additional Information to be Furnished to the Issuer........................97
Administrative Penalty That Respondent shall pay an Administrative Penalty of $1,000.00 to the Participating States to be distributed equally amongst the Participating States (the “per-state payment”).
