Direct Care. Contractor’s direct care staff must assist Individuals with activities in Contractor’s facility, as well as activities and medical appointments in the community, and must be trained in accordance with Section 18 of this Exhibit A, Part 1 Statement of Work. For purposes of this Contract, direct care staffing is outlined below:
Direct Care. Contractor’s direct care staff must assist Individuals with activities in Contractor’s facility as well as activities and medical appointments in the community and must be trained in accordance with Section 15. Training of this Contract. For purposes of this Contract, Contractor shall provide three (3) direct care staff on days, three (3) on evenings and two (2) at night. There shall no less than 2 direct care staff in the building at any time. Contractor shall add staffing when it is warranted by Individual acuity.
Direct Care. The IHS shall seek payment from all other liable payers for Direct Care Services, to the extent feasible and as permissible by law, before seeking reimbursement from VA for Direct Care Services provided to an Eligible AI/AN Veteran under this Agreement. The IHS shall provide VA with copies of Other Health Insurance (OHI), Explanation of Benefits (EOB), Explanation of Payment (EOP), or similar documentation when the IHS receives payment from other liable payers and a balance remains. When IHS receives payment from other liable payers, VA is responsible for only the balance remaining, up to the agreed-upon rates.
Direct Care. Contractor must assure that staffing levels comply with the licensing rules of the facility, OAR Chapter 411 Division 050 rules and assure coverage to meet the scheduled and unscheduled needs of each Client. At a minimum the following ‘Designated” staffing levels must be maintained:
Direct Care. Contractor’s direct care staff must assist Individuals with activities in Contractor’s facility, as well as activities and medical appointments in the community, and must be trained in accordance with Section 14. of this Exhibit A, Part 1 Statement of Work. At least 75 percent of direct care staff must be fluent in American Sign Language and have specialized skills to be able to serve deaf individuals. The remaining 25 percent will participate in ASL training to become fluent. At least one person must be in the building at all times who is fluent in tactile ASL. For purposes of this Contract, direct care staffing is outlined below:
Direct Care. The Independent Contractor shall:
Direct Care. The THP shall seek payment from all other liable payers for Direct Care Services, to the extent feasible and as permissible by law, before seeking reimbursement from VA for Direct Care Services provided to an Eligible American Indian/Alaska Native Veteran under this Agreement. The THP shall provide VA with copies of Other Health Insurance (OHI), Explanation of Benefits (EOB), Explanation of Payment (EOP), or similar documentation when the THP receives payment from other liable payers, VA is responsible for only the balance remaining, up to the agreed-upon rates.
Direct Care. VA will process claims for payment submitted electronically within 30 days of receipt and within 45 days of receipt for claims submitted in paper form. An EOB that satisfies industry standards will be provided by VA to the THP.
