Health and Wellness Services Sample Clauses

Health and Wellness Services. Contractor is required to encourage and monitor the extent to which Plan Enrollees obtain preventive health and wellness services within the first year of enrollment. Contractor shall develop and provide a report annually regarding on how it is maximizing Plan Enrollees access to preventive health and wellness services. Report information should be coordinated with existing national measures, whenever possible, including HEDIS. As part of that report, Contractor shall assess and discuss the participation by Plan Enrollees in:
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Health and Wellness Services. 5.4.1 Which of the following activities are used by the Contractor to encourage use of diagnostic and preventive services? o Mailed printed materials about preventive services with $0 cost-share to members (oral exam, cleaning, X-rays) o Emails sent to membership about preventive services with $0 cost-share to members (oral exam, cleaning, X-rays) o Automated outbound telephone reminders about preventive services with $0 cost-share to members (oral exam, cleaning, X-rays) o Other (please explain) o No current activities used to encourage use of preventive services
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Health and Wellness Services. Contractor is required to actively outreach and monitor the extent to which Exchange Plan Enrollees obtain preventive health and wellness services within the Enrollee’s first year of enrollment. Contractor shall submit information annually to the Exchange related to Plan Enrollees’ access to preventive health and wellness services. Specifically, Contractor shall assess and discuss the participation by Plan Enrollees in necessary diagnostic and preventive services appropriate for each enrollee. Contractor shall annually submit to the Exchange documentation of a health and wellness communication process to Exchange Enrollees and Participating Providers.
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Health and Wellness Services. The term, “Supportive Living,” as used in this Agreement, refers to the personal care, memory support and skilled nursing care components of the Community. Willow Valley Supportive Living environments are designed to provide highly professional skilled nursing, memory support and personal care services to Residents, at no additional cost to Resident over the Monthly Service Fee, except for other charges as outlined under “Types of Supportive Living Services and Supplies Not Provided” in Section 4.2.D below and in accordance with Section 8.1, “Resident Insurance and Indemnification.” Willow Valley agrees that the Resident shall not be liable to a health care provider for the costs of any Health and Wellness Services that Willow Valley has agreed to provide under this Agreement and is unable to provide to Resident, except as outlined in Section 4.2.F. In the event any health care provider seeks payment from Resident for any such health care services that Willow Valley has agreed to provide to Resident under this Agreement, Willow Valley shall assume responsibility for payment of the health care services rendered.
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Health and Wellness Services. Contractor and Participating providers are required to offer and encourage Plan Enrollees to obtain preventive health and wellness services within the first one-hundred and twenty days (120) days of enrollment. At a minimum, Contractor shall identify, assess and provide:
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Health and Wellness Services. Contractor is required to actively outreach and monitor the extent to which Covered California Plan Enrollees obtain preventive health and wellness services within the Enrollee’s first year of enrollment. Contractor shall submit information annually to Covered California related to Plan Enrollees’ access to preventive health and wellness services. Specifically, Contractor shall assess and discuss the participation by Plan Enrollees in necessary diagnostic and preventive services appropriate for each enrollee. Contractor shall annually submit to Covered California documentation of a health and wellness communication process to Covered California Enrollees and Participating Providers.
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Related to Health and Wellness Services

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. Preauthorization may be required for certain surgical services. Reconstructive Surgery for a Functional Deformity or Impairment This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia. Preauthorization may be required for these services.

  • Business Services A. Professional Services

  • Pharmacy Services The Contractor shall establish a network of pharmacies. The Contractor or its PBM must provide at least two (2) pharmacy providers within thirty (30) miles or thirty (30) minutes from a member’s residence in each county, as well as at least two (2) durable medical equipment providers in each county or contiguous county.

  • Mastectomy Services Inpatient This plan provides coverage for a minimum of forty-eight (48) hours in a hospital following a mastectomy and a minimum of twenty-four (24) hours in a hospital following an axillary node dissection. Any decision to shorten these minimum coverages shall be made by the attending physician in consultation with and upon agreement with you. If you participate in an early discharge, defined as inpatient care following a mastectomy that is less than forty-eight (48) hours and inpatient care following an axillary node dissection that is less than twenty-four (24) hours, coverage shall include a minimum of one (1) home visit conducted by a physician or registered nurse.

  • Verizon OSS Services Access to Verizon Operations Support Systems functions. The term “Verizon OSS Services” includes, but is not limited to: (a) Verizon’s provision of Z-Tel Usage Information to Z-Tel pursuant to Section 8.1.3 below; and, (b) “Verizon OSS Information”, as defined in Section 8.1.4 below.

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

  • Clinical Management for Behavioral Health Services (CMBHS) System The CMBHS is the official record of documentation by System Agency. Grantee shall:

  • Child Care A. Employees employed as of March 1 who meet the following criteria shall be eligible for a lump sum payment each year. Eligible employees may apply for this payment between March 1 and April 15 of each year. Payment shall be made within thirty (30) days of receipt of the completed application. Any application received after April 15 will be considered on a case by case basis and shall not be arbitrarily rejected.

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services.

  • Anesthesia Services This plan covers general and local anesthesia services received from an anesthesiologist when the surgical procedure is a covered healthcare service. This plan covers office visits or office consultations with an anesthesiologist when provided prior to a scheduled covered surgical procedure.

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