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- Associate Director of Pharmacy Services, Department of Medicine, University of Washington Medicine, Seattle
This notification will also include the process for submission of this additional information order gabapentin 100mg with amex medications not covered by medicaid, including where it should be sent purchase gabapentin 600mg otc treatment 1st degree heart block. Depending on the nature of the issue in question buy gabapentin 600mg with mastercard medications made from animals, this communication may occur verbally or in writing buy 800 mg gabapentin with amex treatment nurse. If the communication is verbal, written confirmation will be sent at a later date. All communication on the issue(s) in question, including copies of the correspondence or a detailed record of phone calls, will be documented in the practitioner’s credentials file. On request, the practitioner will be provided with the status of their credentialing or recredentialing application. Empire may request and will accept additional information from the applicant to correct or explain incomplete, inaccurate, or conflicting credentialing information. Nondiscrimination Policy Empire will not discriminate against any applicant for participation in its programs or provider network(s) on the basis of race, gender, color, creed, religion, national origin, ancestry, sexual orientation, age, veteran, or marital status or any unlawful basis not specifically mentioned herein. Additionally, Empire will not discriminate against any applicant on the basis of the risk of population they serve or against those who specialize in the treatment of costly conditions. Other than gender and language capabilities which are provided to the members to meet their needs and preferences, this information is not required in the credentialing and re-credentialing process. Determinations as to which practitioners and providers require additional individual review by the Credentials Committee are made according to predetermined criteria related to professional conduct and competence. Credentials Committee decisions are based on issues of professional conduct and competence as reported and verified through the credentialing process. Empire will audit credentialing files annually to identify discriminatory practices, if any, in the selection of practitioners. Should discriminatory practices be 134 | Page identified through audit or through other means, Empire will take appropriate action(s) to track and eliminate those practices. Empire will verify those elements related to an applicants’ legal authority to practice, relevant training, experience and competency from the primary source, where applicable, during the credentialing process. During the credentialing process, Empire will review, among other things, verification of the credentialing data as described in the following tables unless otherwise required by regulatory or accrediting bodies. Practitioners Verification Element License to practice in the state(s) in which the practitioner will be treating Members. If the candidate meets Empire screening criteria, the credentialing process will commence. Ongoing Sanction Monitoring To support certain credentialing standards between the recredentialing cycles, Empire has established an ongoing monitoring program. Credentialing performs ongoing monitoring to help ensure continued compliance with credentialing standards and to assess for occurrences that may reflect issues of 136 | Page substandard professional conduct and competence. To achieve this, the credentialing department will review periodic listings/reports within thirty (30) calendar days of the time they are made available from the various sources including, but not limited to, the following: 1. Clinical Quality Management Department (including data regarding complaints of both a clinical and non-clinical nature, reports of adverse clinical events and outcomes, and satisfaction data, as available) 7. Eligibility Criteria Health care practitioners: Initial applicants must meet the following criteria in order to be considered for participation: A. Possess a current, valid, unencumbered, unrestricted, and non-probationary license in the state(s) where he/she provides services to Members; and C. Individuals no longer eligible for board certification are not eligible for continued exception to this requirement. Training which met the requirements in place at the time it was completed in a specialty field prior to the availability of board certifications in that clinical specialty or subspecialty. Reports submitted by delegate to Empire must contain sufficient documentation to support the above alternatives, as determined by Empire. Also, the organization of an increasing number of physician practice settings in selected fields is such that individual physicians may practice solely in either an outpatient or an inpatient setting. The expectation of these physicians would be that there is an appropriate referral arrangement with a Network practitioner to provide inpatient care. Submission of a complete application and required attachments that must not contain intentional misrepresentations or omissions; 2. Current, valid, unrestricted license to practice in each state in which the practitioner would provide care to Members; 6.
Coverage is subject to order 800mg gabapentin overnight delivery treatment joint pain the terms cheap gabapentin 400 mg on-line treatment xanthelasma, conditions discount gabapentin 600mg online medications 500 mg, and limitations of a Member’s Health Benefit Plan and in accordance with this Policy generic gabapentin 100mg visa symptoms vaginal cancer. There may be times when Empire conducts claim reviews or audits either on a prepayment or post payment basis. Claim reviews and audits are conducted in order to confirm that healthcare services or supplies were delivered in compliance with the Member’s plan of treatment or to confirm that charges were accurately reported in compliance with Empire’s policies and procedures as well as general industry standard guidelines and regulations. In order to conduct such reviews and audits, Empire or its designee may request documentation, most commonly in the form of patient medical records. Empire may accept additional documentation from Provider or Facility that typically might not be included in medical records such as other documents substantiating the treatment or health service or delivery of supplies, Provider’s or Facility’s established internal policies, professional licensure standards that reference standards of care, or business practices justifying the healthcare service or supply. This policy documents Empire’s guidelines for claims requiring additional documentation and the Provider’s or Facility’s compliance for the provision of requested documentation. Definition: the following definitions shall apply to this Audit section only: • Agreement means the written contract between Empire and Provider or Facility that describes the duties and obligations of Empire and the Provider or Facility, and which contains the terms and conditions upon which Empire will reimburse Provider or Facility for Health Services rendered by Provider or Facility to Member(s). The Audit Report shall contain administrative data relating to the Audit, including the amount of overpayment and findings of the Audit, that constitute the basis for Empire’s or its designee’s belief that the overpayment exists. Unless otherwise stated in the Agreement between the Provider or Facility and Empire, Audit Reports shall be sent to Provider or Facility in accordance with the Notice section of the Agreement. A Recoupment is generally performed against a separate payment Empire makes to the Provider or Facility which is unrelated to the services which were the subject of the overpayment, unless an Agreement expressly states otherwise or is prohibited by law. Recoupments shall be conducted in accordance with applicable laws and regulations. Policy Upon request from Empire or its designee, Provider or Facility is required to submit additional documentation for claims identified for pre-payment review or post payment audit. Claims being reviewed to validate items and services billed are documented in the medical record for hospital bill audits (also known as hospital charge audits) 3. Claims for services found to possibly conflict with covered benefits for Members after validity review of the Member’s medical records 6. Claims for services found to possibly conflict with Medical Necessity of covered benefits for Members 7. Claims being reviewed for potential fraud, abuse or demonstrated patterns of billing/coding inconsistent with peer benchmarks 9. Appealed claims where supporting documentation may be necessary for determination of payment 15. Documentation for such services as the provision of durable medical equipment, prosthetics, orthotics, and supplies, rehabilitation services, and home health care Empire or its designee will use the following guidelines for records requests and the adjudication of claims identified for prepayment review or post payment audit: 1. Upon confirmation of Provider’s or Facility’s address, an original letter of request for supporting documentation will be sent. When a response is not received within 30 days of the date of the initial request, a second request letter will be sent. When a response is not received within 15 days of date of the second request, a final request letter will be sent. When a response is not received within 15 days of the date of the final request (60 days total): a. Empire or its designee will initiate a claim denial for claims identified as pre-payment review claims, as Provider or Facility failed to submit the required documentation. Empire or its designee will initiate claim retractions for claims identified as post payment audit claims as Provider or Facility failed to submit the required documentation. Empire or its designee will not be liable for interest or penalties when payment is denied or recouped when Provider or Facility fails to submit required or requested documentation for claims identified for prepayment or post payment audit. Empire or its designee will request in writing or verbally, final and complete itemized bills and/or complete medical records for all Claims under review. The Provider or Facility will supply the requested documentation in the format requested by Empire or its designee within the time frame outlined above. After review of the documents submitted, if Empire or its designee determines an Audit is required, Empire or its designee will call the Provider or Facility to request a mutually satisfactory time for Empire or its designee to conduct an Audit; however, the Audit must occur within forty-five (45) calendar days of the request. Should Provider or Facility desire to reschedule an Audit, Provider or Facility must submit its request with a suggested new date to Empire or its designee in writing at least seven (7) calendar days in advance of the day of the Audit.
The tax credit may not be carried back order 400 mg gabapentin free shipping medications venlafaxine er 75mg, carried forward cheap gabapentin 800 mg with mastercard symptoms breast cancer, or be used to trusted 300 mg gabapentin medicine jar paul mccartney obtain a refund gabapentin 600 mg otc treatment interventions. Within one year after the credit is approved, a taxpayer can apply to the Department of Community and Economic Development for approval to assign or sell eligible credits to another taxpayer. The eligible buyer of the credit may use the purchased credits to offset up to 50 percent of its Pennsylvania tax liabilities. Purpose: this tax credit is intended to encourage the development of an ethane processing industry in the commonwealth. Administrative Costs: Costs to administer the Pennsylvania Resource Manufacturing Tax Credit are borne by the Department of Revenue and the Department of Community and Economic Development. Description: Act 85 of 2012 established the Historic Preservation Incentive Tax Credit for qualified taxpayers owning a Pennsylvania commercial building that qualifies as a certified historical structure according to the Internal Revenue Code. The tax credit is equal to 25 percent of the costs and expenses associated with a plan to rehabilitate a historic structure that is approved by the Pennsylvania Historical and Museum Commission or costs and expenses defined as qualified rehabilitation expenditures under the Internal Revenue Code. The tax credit may be applied to the personal income tax, corporate net income tax, capital stock/foreign franchise tax, gross receipts tax, bank shares tax, title insurance company shares tax, gross premiums tax, and/or mutual thrift institutions tax. The tax credit may not be carried back or used to obtain a refund, but it may be carried forward for up to seven taxable years following the first taxable year for which the taxpayer was entitled to claim the credit. A taxpayer without a qualified tax liability can apply to the Department of Community and Economic Development for approval to assign or sell eligible credits to another taxpayer. Purchasers and assignees of a tax credit must immediately claim the credit in the taxable year in which the purchase or assignment is made. The tax credit is capped at $3 million dollars annually and $500,000 per taxpayer. Purpose: this program encourages taxpayers to rehabilitate and preserve commercial buildings with historical value. Administrative Costs: Costs to administer the Historic Preservation Incentive Tax Credit program are primarily borne by the Department of Community and Economic Development along with the Pennsylvania Historical and Museum Commission and the Department of Revenue. Description: Act 85 of 2012 established Community-Based Services Tax Credit for contributions made by business firms to providers of community-based services for individuals with intellectual disabilities, mental illness, or drug and alcohol addiction. Providers must be a nonprofit entity that provides community-based services to individuals exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code and be approved by the Department of Community and Economic Development. This amount may be increased to 75 percent for business firms that contribute to a provider in two or more successive years. The tax credit may be applied to the personal income tax, corporate net income tax, capital stock/foreign franchise tax, bank shares tax, title insurance company shares tax, insurance premiums tax, and/or mutual thrift institutions tax. Tax credits may not be carried forward, carried back, and are not refundable or transferable. The total amount of credits per business firm cannot exceed $100,000 annually, and the total aggregate amount of all credits approved cannot exceed $3 million in a fiscal year. The first and last years that the credit may be applied to are fiscal years 2013-14 and 2020-21, respectively. Purpose: this program encourages taxpayers to contribute to providers community-based services. Administrative Costs: Costs to administer the Community-Based Services Tax Credit program are primarily borne by the Department of Community and Economic Development along with the Department of Human Services and the Department of Revenue. Description: Act 52 of 2013 created the Mobile Telecommunications Broadband Investment Tax Credit. Taxpayers that are a provider of mobile communications services shall be allowed a tax credit against their corporate net income tax for investment in qualified broadband equipment placed into service in Pennsylvania. The amount of the tax credit is five percent of the purchase price of qualified broadband equipment put into service during the taxable year. The maximum amount of approved tax credits shall not exceed $5 million in any fiscal year, nor may they exceed 50 percent of a taxpayer’s corporate net income tax liability. Any credit claimed and not used in the taxable year may be carried forward for no more than five consecutive tax years. Affiliated shareholders, members, or partners of pass-through entities that receive unused credits from the pass-through entity are required to use the tax credit immediately. They are not allowed to carry forward, carry back, obtain a refund, or sell the tax credit. Purpose: the tax credit is intended to encourage investment in mobile broadband services by the mobile telecommunications industry. Administrative Costs: Costs to administer the Mobile Telecommunications Broadband Investment Tax Credit are borne by the Department of Revenue.
Songs of blacks show that their rhythmical and structural elements came from Africa buy generic gabapentin 100 mg line medicine for pink eye, although the product is native American generic gabapentin 400mg treatment xanthelasma eyelid. Helena most was the Ring Shout order gabapentin 400mg fast delivery treatment quad strain, a dance of religious ecstasy gabapentin 800 mg treatment concussion, half pow wow, half prayer meeting, with chants and song, seen as barbaric by most whites who did not appreciate its meaning and origin. Work songs were also common on the Sea Islands, whether in rowing boats or thrashing rice sheaves. Dance also characterized life on the sea islands, often reflecting work patterns, as in “New Rice an’ Okra,” when scuffing off the outside husks of rice. Rhythm and improvisation, that characterized dance and song, were a group activity and a part of everyday life. Music fills the life of the African from birth to death, closely associated with the gods, magic, and healing. A wide variety of native instruments are played there, including drums and fiddles, and the bania, the forerunner of the banjo; but the human voice is the crowning instrument. Even on the slave ship; the memory of African music was kept alive, and in America black mothers passed on melodies to their children. The ring shout, songs, spirituals, and instruments of the Sea Islands can be traced to Africa. Music from Africa was retained among the Gullah because it expressed feelings of joy or of grief, promoted physical and spiritual well being, provided escape from drudgery, molded the young, and fostered a sense of community. Slaves speaking different tongues could communicate feelings in this universal language, and music at funerals united the living with the dead. Sacred songs, echoing religion, evolved from the syncretism of Christianity and African belief, and some also contained a veiled cry for freedom. One other activity transmitted to the Sea Islands that kept alive memories and raised the morale of the people provides another opportunity to discover both African roots and adaptation in a new environment. Thereby Hangs a Tale: Folklore the story of the mock plea of Brother Rabbit who is thrown into the briar patch that he pretends to fear, familiar for more than a century to millions since childhood, is one of the well known animal tales of Uncle Remus by Joel Chandler Harris. When the speaker imitates the whining and whimpering of Ber Rabbit and adds the squinched eyes, wrinkled nose, gestures of face and hands, and bodily movements, his listeners go wild with laughter. Many cantefables, or "singing tales," abound on the sea islands where they have educated and delighted the inhabitants for generations. The Tar Baby of well nigh universal distribution is another favorite in coastal Carolina. Why the wide appeal of the short accounts of talking animals, mythical creatures, and heroes of extraordinary powers Some serve as escape literature; some explain the origin of the cosmos and its creatures; others are instructive; and in some settings they may contain a hidden message. The same stories are spread over many lands; those collected are only a fraction of all known to a people, and they are filtered through alien listeners; two tales with the same theme are not identical in content or style; through improvisation the tale is transformed with each telling; and the setting, gestures, intonations, acting, and even audience response are just as important as the story itself. Missionaries and travelers were aware of the rich vein of tales that natives of Africa told, intertwined with their history and mythology. Stories from Sierra Leone, told in dialect, usually at night around a D36 Low Country Gullah Culture Special Resource Study campfire, display the dramatic power of the storyteller and the musical quality of the chants accompanied by the clapping of hands. The trickster animal is widely known and loved; physically insignificant, seemingly helpless, and yet endowed with extraordinary mental acumen, his triumphs are an approved outlet for difficulties experienced by oppressed people. Tales of the small animal who outwits bigger ones are widespread throughout Africa, frequently the rabbit in Sierra Leone and Nnabe, the turtle, on the Slave Coast. Shrewd and designing, selfish, deceitful, and sometimes cruel, the spider appears in half of the folk tales of West Africa. This wily creature is well known in the West Indies too, where his scheming nature reflects the subtlety necessary for survival, and connects Africa, the Caribbean, and Carolina. Helena, they became aware of the rich treasure of stories known to the people of the region. The most complete collection of sea island tales was made by the folklorist Elsie Clews Parsons. Her densely packed volume (1923) contains 178 tales, many of them with several variants, plus riddles, proverbs, toasts, verses, songs, folkways, and notions, told in dialect. Here one finds animals well known to southerners dog, fox, wolf, rat, cat, bullfrog, alligator, turtle, squirrel, raccoon, partridge, rooster, crane, chicken, duck, and rattlesnake.
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