Common use of Contract Responsibilities Clause in Contracts

Contract Responsibilities. Under the Contract, Contractor is required by law to conduct quality and utilization review activities that identify, evaluate and remedy problems relating to access, continuity and quality of care, utilization and the cost of services. Accordingly, Participating Provider shall comply with Contractor’s quality and utilization review program which shall: (i) maintain standards, policies and procedures for credentialing and re-credentialing dentists and other health care professionals and facilities providing Covered Services to Enrollees, (ii) include the establishment of peer review panels and committees to conduct quality of care and utilization review activities in accordance with applicable state and federal laws and regulations, and (iii) may engage accreditation or review organizations in connection with its quality and utilization review activities. All quality and utilization review forms, records and other information in the possession of Contractor shall remain the property of Contractor and shall remain confidential Contractor will make available all documents, procedures and other administrative policies and programs referenced in the Contract available for review by a provider prior to execution of this Agreement through a dedicated website.