Common use of Access Standards Clause in Contracts

Access Standards. 5.9.1. A request for services as defined in 2.8.1. in definitions may be made through a telephone call, walk-in, or written request from an Enrollee or those defined as authorized representative in this Agreement. 5.9.1.1. The Contractor must verify eligibility for Title XIX prior to the provision of non-crisis services to an Enrollee. 5.9.1.2. The Contractor must maintain documentation of all requests for service even if no service actually occurs. If no service occurs the Contractor must document the reason. This documentation must be provided to Great Rivers upon request. 5.9.1.3. The Contractor must not refer a Washington Apple Health Enrollee to the Enrollee’s Washington Apple Health managed care plan for behavioral health services if the Enrollee is determined to be eligible based on Medical Necessity and the Access to Care Standards for BHOs.