FQHCs and RHCS Sample Clauses

FQHCs and RHCS. The MCO will submit a quarterly data report of FQHC or RHC copayments for service dates on or after January 1, 2015 in accordance with section 3.8(C) below. In the event that a FQHC/RHC contacts the MCO or the STATE regarding payments made to the FQHC/RHC prior to January 1, 2015, but not included in any submitted report, the MCO shall review, and if appropriate, must submit the missing data. Within eight (8) business days of receipt of this report, the STATE shall provide the MCO a return file that contains incorrect data lines that cannot be read by the system and loaded. The MCO must review the data lines and correct appropriately. Corrected data lines must be resubmitted within thirty (30) days, and shall be reported separately as a corrected file. The MCO shall not resubmit data already submitted and accepted. Payment for ad hoc Reporting. The STATE may require reimbursement at standard rates for ad hoc reports requested of the STATE. For the purposes of this section, “standard rates” means those listed in the STATE policy “DHS Policies and Procedures for Handling Protected Information: 2.60 Data Requests and Copy Costs” available at xxxx://xxx.xxx.xxxxx.xx.xx/id_017855. Reporting on MSHO Stakeholder Group. For the MCO’s local or regional stakeholder group (as required in section 7.4.4) the MCO will submit to the STATE twice per Contract Year, on or before June 15th and December 15th, documentation in the form of stakeholder meeting agendas and meeting minutes that demonstrate the MCO response to significant concerns raised by stakeholder group participants. The STATE shall provide the MCO with an electronic listing of all enrolled MHCP Providers and their NPI or UMPI numbers on a monthly basis. The MCO must update the Provider identification numbers by submitting, for Providers who are new to the MCO and do not already have a STATE Provider number (UMPI) or NPI, current complete demographic information about the Provider, on a form approved by the STATE. The MCO shall not require Providers to enroll as an MHCP FFS Provider. If a Provider will only be serving MCO Enrollees, the MCO shall follow the process established by the STATE for MCO-only Providers. Payment Review Information. The MCO shall identify aggregate payment information for specific Provider categories and assess the information as to how it compares to FFS payment information. As part of the assessment the MCO will also be expected to provide an explanation of the basis for how the Prov...
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FQHCs and RHCS. The MCO will submit a quarterly data report of FQHC or RHC copayments for service dates on or after January 1, 2015 in accordance with section 3.7(C) below. In the event that a FQHC/RHC contacts the MCO or the STATE regarding payments made to the FQHC/RHC prior to January 1, 2015, but not included in any submitted report, the MCO shall review, and if appropriate, must submit the missing data. Within eight (8) business days of receipt of this report, the STATE shall provide the MCO a return file that contains incorrect data lines that cannot be read by the system and loaded. The MCO must review the data lines and correct appropriately. Corrected data lines must be resubmitted within thirty (30) days, and shall be reported separately as a corrected file. The MCO shall not resubmit data already submitted and accepted.
FQHCs and RHCS. The MCO shall provide to the STATE a quarterly report for the first quarter of Contract Year 2010, due no later than thirty (30) days following the end of the quarter. The report must identify MCO payments made to FQHCs and RHCs for all programs covered under this Contract. As of April 1st of Contract Year, reports shall be submitted monthly, with the first monthly report due no later than May 31, 2010.
FQHCs and RHCS. The MCO shall provide to the STATE a monthly report to identify MCO payments made to FQHCs and RHCs for all programs covered under this Contract.
FQHCs and RHCS. The MCO will submit a quarterly data report of FQHC or RHC copayments for service dates on or after January 1, 2015 in accordance with section 3.7(C) below.
FQHCs and RHCS. In the event that a FQHC/RHC contacts the MCO or the STATE regarding payments made to the FQHC/RHC prior to January 1, 2015, but not included in any submitted report, the MCO shall review, and if appropriate, must submit the missing data.

Related to FQHCs and RHCS

  • Ambulance Escort Where a nurse is assigned to provide patient care for a patient in transit, the following provisions shall apply:

  • Green Economy/Carbon Footprint a) The Supplier/Service Provider has in its bid provided Transnet with an understanding of the Supplier’s/Service Provider’s position with regard to issues such as waste disposal, recycling and energy conservation.

  • MEDICALLY FRAGILE STUDENTS 1. If a teacher will be providing instructional or other services to a medically fragile student, the teacher or another adult who will be present when the instruction or other services are being provided will be advised of the steps to be taken in the event an emergency arises relating to the student's medical condition.

  • Outpatient If you receive dialysis services in a hospital's outpatient unit or in a dialysis facility, we cover the use of the treatment room, related supplies, solutions, drugs, and the use of the dialysis machine. In Your Home If you receive dialysis services in your home and the services are under the supervision of a hospital or outpatient facility dialysis program, we cover the purchase or rental (whichever is less, but never to exceed our allowance for purchase) of the dialysis machine, related supplies, solutions, drugs, and necessary installation costs. Related Exclusions If you receive dialysis services in your home, this agreement does NOT cover: • installing or modifying of electric power, water and sanitary disposal or charges for these services; • moving expenses for relocating the machine; • installation expenses not necessary to operate the machine; or • training you or members of your family in the operation of the machine. This agreement does NOT cover dialysis services when received in a doctor’s office.

  • Chiropractic Services This plan covers chiropractic visits up to the benefit limit shown in the Summary of Medical Benefits. The benefit limit applies to any visit for the purposes of chiropractic treatment or diagnosis.

  • Volunteer Peer Assistants 1. Up to eight (8)

  • Primary Care Clinic Employees and each of their covered dependents must individually elect a primary care clinic within the network of providers offered by the plan administrator chosen by the employee. Employees and their dependents may elect to change clinics within their clinic’s Benefit Level as often as the plan administrator permits and as outlined above.

  • Prosthodontics We Cover prosthodontic services as follows: • Removable complete or partial dentures, for Members 15 years of age and above, including six (6) months follow-up care; • Additional services including insertion of identification slips, repairs, relines and rebases and treatment of cleft palate; and • Interim prosthesis for Members five (5) to 15 years of age. We do not Cover implants or implant related services. Fixed bridges are not Covered unless they are required: • For replacement of a single upper anterior (central/lateral incisor or cuspid) in a patient with an otherwise full complement of natural, functional and/or restored teeth; • For cleft palate stabilization; or • Due to the presence of any neurologic or physiologic condition that would preclude the placement of a removable prosthesis, as demonstrated by medical documentation.

  • Outpatient Services The following services are covered only at the Primary Care Provider’s office[selected by a [Member], or elsewhere [upon prior written Referral by a [Member]'s Primary Care Provider ]:

  • Immunizations (except for those preventive immunizations for routine use in children, adolescents, and adults that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention);

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