Responding to Direct Requests By a Member for a Service Sample Clauses

Responding to Direct Requests By a Member for a Service. When a member requests a health or long-term care service or item, IDT staff shall do all of the following: Acknowledge receipt of the request and explain to the member the process to be followed in processing the request; Using the RAD or other Department approved guidelines, promptly determine what the core issue is in relation to the request. Assess if the request meets a need defined in the member’s long term outcomes.
Sample 1Sample 2Sample 3See All (7)
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Responding to Direct Requests By a Member for a Service. When a member requests a health or long-term care service or item, IDT staff shall do all of the following:
Sample 1Sample 2Sample 3See All (6)
Responding to Direct Requests By a Member for a Service. When a member requests a health or long-term care service or item, IDT staff shall do all of the following: Acknowledge receipt of the request and explain to the member the process to be followed in processing the request; Using the RAD or other Department approved guidelines, promptly determine what the core issue is in relation to the request. Assess if the request meets a need defined in the member’s long term outcomes. Promptly determine whether the IDT has the authority to authorize the requested service or whether the authorization decision must be made outside the IDT (see Section K.4., Service Authorization Decisions Made Outside the IDT, in this article); Consult as needed with other health care professionals who have appropriate clinical expertise in treating the member's condition or disease necessary to reach a service authorization decision. Issue a prompt decision as follows:
Sample 1
Responding to Direct Requests By a Member for a Service. When a member requests a health or long-term care service or item, IDT staff shall do all of the following: Acknowledge receipt of the request and explain to the member the process to be followed in processing the request; Using the RAD or other Department approved guidelines, promptly determine what the core issue is in relation to the request. Assess if the request meets a need defined in the member’s long-term outcomes. Determine whether the request is for an item or service included in the Family Care Benefit package; if not, the MCO may authorize the service only if it complies with the requirements set forth in Article VII.A.7.; Promptly determine whether the IDT has the authority to authorize the requested service or whether the authorization decision must be made outside the IDT. See Article V.K.4., Service Authorization Decisions Made Outside the IDT; Consult as needed with other health care professionals who have appropriate clinical expertise in treating the member's condition or disease necessary to reach a service authorization decision. Issue a prompt decision as follows:
Sample 1
Responding to Direct Requests By a Member for a Service. When a member requests a health or long-term care service or item, IDT staff shall do all of the following: Acknowledge receipt of the request and explain to the member the process to be followed in processing the request; Using the MCO’s DHS-approved guidelines, promptly determine what the core issue is in relation to the request. Assess if the request meets a need defined in the member’s long term outcomes; Determine whether the request is for an item or service included in the Family Care Benefit package (if not, the IHCP may authorize the service only if it complies with the requirements set forth in Article VI.B.); Consult as needed with other health care professionals who have appropriate clinical expertise in treating the member's condition or disease necessary to reach a service authorization decision; Issue a prompt decision as follows:
Sample 1

Related to Responding to Direct Requests By a Member for a Service

  • Responding to Requests The Freedom of Information Officer shall approve all requests for public records unless:

  • Examination of an application for an industrial design 1. A formal examination of the application for an industrial design received by the federal executive authority for intellectual property is carried out which includes checks on presence of the documents specified in clause 2 of Article 1377 of the Civil Code of the Russian Federation and its compliance with the established requirements. If the result of the formal examination is positive, then a substantive examination of an application for an industrial design is carried out, which includes: information search in relation to the claimed industrial design to determine the publicly available information, which shall be taken into account when examining the design patentability; examination of the claimed industrial design for the compliance with the requirements under Article 1231.1, clause 4 of Article 1349 of the Civil Code of the Russian Federation, and the patentability criteria under the first paragraph of clause 1, clause 5 of Article 1352 of the Civil Code of the Russian Federation; examination of the claimed industrial design for the compliance with the patentability criteria under the second paragraph of clause 1 of Article 1352 of the Civil Code of the Russian Federation. An information search in relation to the objects specified in sub-clause 4 of clause 4 of Article 1349 of the Civil Code of the Russian Federation shall not be carried out, and the federal executive authority on intellectual property notifies the applicant about it. 2. If, as a result of the substantive examination of an application for an industrial design, it is found that the claimed industrial design represented on the reproductions of an external appearance of the article does not relate to the objects specified in Article 1231.1 or clause 4 of Article 1349 of the Civil Code of the Russian Federation and meets the patentability criteria under Article 1352 of the Civil Code of the Russian Federation, the federal executive authority for intellectual property makes a decision to grant a patent for an industrial design. The date of filing of the application for the industrial design and the priority date of the industrial design shall be specified in the decision. If, during the process of substantive examination of an application for an industrial design, it is found that the claimed object does not meet at least one of the requirements or patentability criteria specified in paragraph one of this clause, the federal executive authority for intellectual property makes a decision to refuse the issuance of a patent.

  • Participating TO Retail Metering The Participating TO may install retail revenue quality meters and associated equipment, pursuant to the Participating TO’s applicable retail tariffs.

  • RESPONDING TO REQUESTS FOR INFORMATION To the extent authorized by the Participating Consumer(s) and to the extent such individual permission is required by law, the Competitive Supplier shall, during normal business hours (as set forth above), respond promptly and without charge therefore to reasonable requests of the Town for information or explanation regarding the matters covered by this ESA and the supply of electricity to Participating Consumers. Competitive Supplier agrees to designate a service representative or representatives (the “Service Contacts”) who shall be available for these purposes, and shall identify the office address and telephone number of such representative(s). Whenever necessary to comply with this Article 5.3, the Service Contacts shall call upon other employees or agents of the Competitive Supplier to obtain such information or explanation as may be reasonably requested. Nothing in this Article 5.3 shall be interpreted as limiting the obligation of the Competitive Supplier to respond to complaints or inquiries from Participating Consumers, or to comply with any regulation of the Department or AG regarding customer service.

  • Notice of Network Changes If a Party makes a change in the information necessary for the transmission and routing of services using that Party’s facilities or network, or any other change in its facilities or network that will materially affect the interoperability of its facilities or network with the other Party’s facilities or network, the Party making the change shall publish notice of the change at least ninety (90) days in advance of such change, and shall use reasonable efforts, as commercially practicable, to publish such notice at least one hundred eighty (180) days in advance of the change; provided, however, that if an earlier publication of notice of a change is required by Applicable Law (including, but not limited to, 47 CFR 51.325 through 51. 335) notice shall be given at the time required by Applicable Law.

  • Termination of an Order Form for Convenience Except as otherwise agreed in an Order Form, each Order Form (excluding fixed-price Services and excluding subscription or monthly reoccurring Services) may be terminated by either party subject to thirty (30) days’ prior written notice to the other party.

  • Data Subject Requests To the extent legally permitted, Okta shall promptly notify Customer if Okta receives a request from a Data Subject to exercise the Data Subject's right of access, right to rectification, restriction of Processing, erasure (“right to be forgotten”), data portability, object to the Processing, or its right not to be subject to an automated individual decision making (“Data Subject Request”). Factoring into account the nature of the Processing, Okta shall assist Customer by appropriate organizational and technical measures, insofar as this is possible, for the fulfilment of Customer’s obligation to respond to a Data Subject Request under Data Protection Laws and Regulations. In addition, to the extent Customer, in its use of the Service, does not have the ability to address a Data Subject Request, Okta shall, upon Customer’s request, provide commercially- reasonable efforts to assist Customer in responding to such Data Subject Request, to the extent that Okta is legally authorized to do so, and the response to such Data Subject Request is required under Data Protection Laws and Regulations. To the extent legally permitted, Customer shall be responsible for any costs arising from Okta’s provision of such assistance.

  • Term of an Order Form or Service Each Order Form and Service shall be effective on the effective date set forth in that Order Form, and shall remain in effect until end of term or completion of the Services in accordance with the Order Form, the respective Scope Document, or terminated earlier by either party in accordance with this Section 7. For the avoidance of doubt, the termination of any particular Service in accordance with this Section 7 shall not cause or result in the termination of any other Services ordered under the same Order Form nor reduce Prime Contractor’s liability for payments to SAP.

  • How to Obtain Warranty Service The Warranty Holder must inspect the Flooring for Manufacturing Defects caused by improper milling, grading, staining and coating, and report any such defects to Cali Bamboo, prior to installation of the Flooring. To obtain warranty service, the Warranty Holder must contact Cali Bamboo’s Customer Experience Department: xxxxxxxxxxxxxxx@xxxxxxxxxx.xxx/ 000-000-0000. Warranty claims must be received within 30 calendar days after the Warranty Holder identifies the Manufacturing Defect or other basis for a warranty claim. To be covered under this Cali Bamboo limited warranty, the Warranty Holder must provide documentation of sales order and proof that the Flooring was properly installed in accordance with the Installation Guide (defined below). Cali Bamboo reserves the right to retain a certified and independent flooring inspector to verify the Warranty Holder’s warranty claims. The determination of the flooring inspector regarding the warranty claim is not binding on either Cali Bamboo or on the Warranty Holder. A determination that does not verify the warranty claim shall not affect the Warranty Holder’s right to submit its claim to arbitration in accordance with the terms of the Arbitration Agreement (as defined in Cali Bamboo’s Terms and Conditions of Purchase). The performance of the inspection, however, if requested by Xxxx Xxxxxx and assuming that Xxxx Xxxxxx advances the full cost of the inspection as described above, is a requirement for the Warranty Holder to submit a warranty claim to arbitration under the Arbitration Agreement. For specific instructions on how to obtain warranty service for defective Flooring, visit the Cali Bamboo website xxxxx://xxx.xxxxxxxxxx.xxx/geowood-flooring-warranty/. Warranty Exclusions and Limitations: This limited warranty covers Flooring that is both (i) installed with strict adherence to Cali Bamboo’s GeoWood flooring installation guide found online at xxxxx://xxx.xxxxxxxxxx.xxx/flooring-installation/ (the “Installation Guide”) and (ii) maintained in accordance with Cali Bamboo’s GeoWood flooring care and maintenance guidelines found online at xxxxx://xxx.xxxxxxxxxx.xxx/floor-care-and-maintenance/ (the “Maintenance Guide”). Cali Bamboo will provide copies of these guides upon request by the Warranty Holder. This limited warranty only applies when the Flooring is used under normal traffic and other usage conditions. The limited warranty for Manufacturing Defects does not apply after the Warranty Holder has installed the Flooring, and product variation or error that does not exceed the 5% industry standard is not considered a Manufacturing Defect for purposes of this limited warranty. This limited warranty does not extend to or cover:

  • Providing Notice of Breaches 8.1 If Covered Entity determines that an impermissible acquisition, access, use or disclosure of PHI for which one of Business Associate’s employees or agents was responsible constitutes a Breach as defined in 45 CFR § 164.402, and if requested by Covered Entity, Business Associate shall provide notice to the individual(s) whose PHI has been the subject of the Breach. When requested to provide notice, Business Associate shall consult with Covered Entity about the timeliness, content and method of notice, and shall receive Covered Entity’s approval concerning these elements. The cost of notice and related remedies shall be borne by Business Associate.

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