Behavioral Health Care Sample Clauses

Behavioral Health Care. In addition to the general provisions for Behavioral Health Care Services required in Attachment II, Section VI, Behavioral Health Care, the Health Plan shall provide the following medically necessary community behavioral health services as required for the treatment and coordination of care for enrollees of the Health Plan:
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Behavioral Health Care. ‌ Requests for behavioral health care and prescriptions are subject to the same prior and retroactive authorization processes and timelines as requests for medical care and prescriptions. Authorization Denial We will inform you in writing if we deny a prior or retroactive authorization request. Our notice to you will explain why we denied the request and will provide you with instructions for disputing our decision if you disagree. A summary of the dispute resolution process is included in this document. Please refer to the Table of Contents. You have a right to request information about the guidance we followed to deny your request, even if you do not dispute our decision. Endorsement 2‌ THIS ENDORSEMENT MAY CHANGE YOUR AGREEMENT WITH US. IF THE TERMS OF THIS ENDORSEMENT CONFLICT WITH ANY INFORMATION IN YOUR EOC, THE TERMS OF THIS ENDORSEMENT CONTROL. OUT-OF-NETWORK CARE AND BILLS If you receive care under any of the circumstances below from a provider who is not in your network, these are your rights: If you receive emergency care out-of-network, including air ambulance service: • You are only responsible for paying what you would owe for the same care from an in- network provider or facility. • You do NOT need to get prior authorization for emergency services. • Your care can continue until your condition has stabilized. If you require additional care after stabilization, call us at (000) 000-0000 and we will help you receive that care from an in-network provider. • You cannot be balance billed. If you receive care from an out-of-network provider at an in-network facility, such as a hospital that is in your plan, you are only responsible for paying what you would owe for the same care from an in-network provider if: • you did not consent to services from an out-of-network provider, • you were not offered the service from an in-network provider, or • the service was not available from an in-network provider - as determined by your healthcare provider and your health insurance company. If you get a bill from an out-of-network provider under any of the above circumstances that you do not believe is owed: • Call us first at (000) 000-0000. We will try to the resolve the issue with the provider on your behalf. • Contact the New Mexico Office of Superintendent of Insurance if the problem has not been resolved by us - xxx.xxx.xxxxx.xx.xx or 1-855-4ASK-OSI (0-000-000-0000). To help stop improper out-of-network bills, we will: • Notify you if your provider leave...
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Behavioral Health Care. Background: Recognizing that the public health emergency, necessary mitigation measures like social distancing, and the economic downturn have exacerbated mental health and substance use challenges for many Americans, the interim final rule included an enumerated eligible use for mental health treatment, substance use treatment, and other behavioral health services, including a non-exhaustive list of specific services that would be eligible under this category. Public Comment: Many commenters expressed support for the interim final rule’s recognition of behavioral health impacts of the pandemic and eligible uses under this category. Several commenters requested clarification on the types of eligible services under this category, specifically whether both acute and chronic care are included as well as services that often do not directly accept insurance payments, like peer support groups. Some commenters highlighted the importance of cultural competence in providing effective behavioral health services. Some commenters suggested that funding should be available broadly and quickly for this purpose, recommending that funding available for behavioral health not be tied to the amount of revenue loss experienced by the recipient.
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Behavioral Health Care. A. The CONTRACTOR shall:
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Behavioral Health Care. MAHP has established policies and procedures to ensure access to medical care for members needing behavioral health care and to establish standards for access. A Behavioral Health Practitioner is a member of the QIC. QIC focuses on improving Behavioral Health care through monitoring of HEDIS measures. Our open electronic medical record ensures communication, continuity, and coordination of care between referring and treating practitioners.
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Behavioral Health Care 
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Related to Behavioral Health Care

  • Health Care The Company will reimburse the Executive for the cost of maintaining continuing health coverage under COBRA for a period of no more than 12 months following the date of termination, less the amount the Executive is expected to pay as a regular employee premium for such coverage. Such reimbursements will cease if the Executive becomes eligible for similar coverage under another benefit plan.

  • Continued Healthcare If Executive elects to receive continued healthcare coverage pursuant to the provisions of COBRA, the Company shall directly pay, or reimburse Executive for, the premium for Executive and Executive’s covered dependents through the earlier of (i) the first anniversary of the date of Executive’s termination of employment and (ii) the date Executive and Executive’s covered dependents, if any, become eligible for healthcare coverage under another employer’s plan(s). Notwithstanding the foregoing, (i) if any plan pursuant to which such benefits are provided is not, or ceases prior to the expiration of the period of continuation coverage to be, exempt from the application of Section 409A of the Code under Treasury Regulation Section 1.409A-1(a)(5), or (ii) the Company is otherwise unable to continue to cover Executive under its group health plans without penalty under applicable law (including without limitation, Section 2716 of the Public Health Service Act), then, in either case, an amount equal to each remaining Company subsidy shall thereafter be paid to Executive in substantially equal monthly installments. After the Company ceases to pay premiums pursuant to this Section 4(c), Executive may, if eligible, elect to continue healthcare coverage at Executive’s expense in accordance the provisions of COBRA.

  • Education Associate’s or Bachelor’s Degree, or technical institute degree/certificate in Computer Science, Information Systems or other related field. Or equivalent work experience.

  • Health Care Compliance Neither the Company nor any Affiliate has, prior to the Effective Time and in any material respect, violated any of the health care continuation requirements of COBRA, the requirements of FMLA, the requirements of the Health Insurance Portability and Accountability Act of 1996, the requirements of the Women's Health and Cancer Rights Act of 1998, the requirements of the Newborns' and Mothers' Health Protection Act of 1996, or any amendment to each such act, or any similar provisions of state law applicable to its Employees.

  • Virus Management Transfer Agent shall maintain a malware protection program designed to deter malware infections, detect the presence of malware within the Transfer Agent environment.

  • Healthcare Compliance 10 (v) Fraud and Abuse................................................11 (w)

  • Medical Services We do not Cover medical services or dental services that are medical in nature, including any Hospital charges or prescription drug charges.

  • Health Care Benefits (a) Each regular full-time employee may elect coverage for himself and his eligible dependents* under one of the following health insurance plans:

  • REGULATORY ADMINISTRATION SERVICES BNY Mellon shall provide the following regulatory administration services for each Fund and Series:  Assist the Fund in responding to SEC examination requests by providing requested documents in the possession of BNY Mellon that are on the SEC examination request list and by making employees responsible for providing services available to regulatory authorities having jurisdiction over the performance of such services as may be required or reasonably requested by such regulatory authorities;  Assist with and/or coordinate such other filings, notices and regulatory matters and other due diligence requests or requests for proposal on such terms and conditions as BNY Mellon and the applicable Fund on behalf of itself and its Series may mutually agree upon in writing from time to time; and

  • Medical Examination Where the Employer requires an employee to submit to a medical examination or medical interview, it shall be at the Employer's expense and on the Employer's time.

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