Information for ODM-Designated Providers Sample Clauses

Information for ODM-Designated Providers. The MCO must share specific information with federally qualified health centers (FQHCs)/rural health clinics (RHCs), qualified family planning providers, hospitals, and if applicable, certified nurse midwives, certified nurse practitioners, and free-standing birth centers as defined in OAC rule 5160-18-01 within the MCO's service area and in bordering regions, if appropriate, based on member utilization information. The information must be shared within the first month after the MCO has been awarded a Medicaid provider agreement for a specific region and annually thereafter. At a minimum, the information must include the following: The information's purpose; Claims submission information, including the MCO's Medicaid provider number for each region (this information must only be provided to out-of- network FQHCs/RHCs, qualified family planning providers, certified nurse midwives, certified nurse practitioners, and hospitals). Claims submission information must include 30 calendar day advance notice to providers of any new edits or system changes related to claims adjudication or payment keyprocessing; The MCO's prior authorization and referral procedures; A picture of the MCO ID card (front and back); Contact numbers for obtaining information for eligibility verification, claims processing, referrals, prior authorization, post-stabilization care services, and if applicable, information regarding the MCO's behavioral health administrator; and A listing of the MCO's laboratories and radiology providers.
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Information for ODM-Designated Providers i. The OhioRISE Plan must share specific information with CMEs, MRSS (including referrals from MRSS for children who may be eligible for the OhioRISE Program due to a crisis), Intensive Home Based Treatment providers, federally qualified health centers (FQHCs)/rural health clinics (RHCs), hospitals offering inpatient psychiatric and/or inpatient substance use disorder services, and other behavioral health providers identified in Appendix B, Coverage and Services.
Information for ODM-Designated Providers i. The MCO must share specific information with federally qualified health centers (FQHCs)/rural health clinics (RHCs), qualified family planning providers, hospitals, and if applicable, certified nurse midwives, certified nurse practitioners, and free-standing birth centers as defined in OAC rule 5160-18-01 within the MCO's service area and in bordering regions, if appropriate, based on member utilization information.

Related to Information for ODM-Designated Providers

  • Excluded Providers 6.4.1 Definition of Excluded Providers In accordance with 42 CFR 438.214(d), the Contractor may not employ or contract with Providers who are Excluded from participation in Federal Health Care Programs under either Section 1128 or 1128(A) of the Social Security Act.

  • Participating Providers To find out if a Provider is a Participating Provider: • Check Our Provider directory, available at Your request; • Call the number on Your ID card; or • Visit our website at xxx.xxxxxx.xxx. The Provider directory will give You the following information about Our Participating Providers: • Name, address, and telephone number; • Specialty; • Board certification (if applicable); • Languages spoken; and • Whether the Participating Provider is accepting new patients.

  • The Web Services E-Verify Employer Agent agrees to, consistent with applicable laws, regulations, and policies, commit sufficient personnel and resources to meet the requirements of this MOU.

  • Use of local labour professional services and materials 10. (1) The Company shall, for the purposes of this Agreement —

  • Services and Third Party Materials A. The tvOS Software may enable access to Apple’s iTunes Store, App Store, Game Center, iCloud and other Apple and third party services, and web sites (collectively and individually, “Services”). Such Services may not be available in all languages or in all countries. Use of these Services requires Internet access and use of certain Services may require an Apple ID, may require you to accept additional terms and may be subject to additional fees. By using this software in connection with an Apple ID, or other Apple Service, you agree to the applicable terms of service for that Service, such as the latest iTunes Store Terms and Conditions, which you may access and review at xxxx://xxx.xxxxx.xxx/legal/itunes/ ww/.

  • Provisions for Covered Entity to Inform Business Associate of Privacy Practices and Restrictions (a) Covered Entity shall notify Business Associate of any limitation(s) in the notice of privacy practices of Covered Entity under 45 CFR 164.520, to the extent that such limitation may affect Business Associate’s use or disclosure of protected health information.

  • Dissemination of Research Findings and Acknowledgement of Controlled-Access Datasets Subject to the NIH GDS Policy It is NIH’s intent to promote the dissemination of research findings from use of controlled-access dataset(s) subject to the NIH GDS Policy as widely as possible through scientific publication or other appropriate public dissemination mechanisms. Approved Users are strongly encouraged to publish their results in peer-reviewed journals and to present research findings at scientific meetings.

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  • Your Guide to Selecting a Primary Care Provider (PCP) and Other Providers Quality healthcare begins with a partnership between you and your primary care provider (PCP). When you need care, call your PCP, who will help coordinate your care. Your healthcare coverage under this plan is provided or arranged through our network of PCPs, specialists, and other providers. You’re encouraged to: • become involved in your healthcare by asking providers about all treatment plans available and their costs; • take advantage of the preventive health services offered under this plan to help you stay healthy and find problems before they become serious. Each member is required to provide the name of his or her PCP. However, if the name of a PCP is not provided with the application, your enrollment will not be delayed and your coverage will not be cancelled. How to Find a PCP or Other Providers Finding a PCP in our network is easy. To select a provider, or to check that a provider is in our network, please use the “Find a Doctor” tool on our website or call Customer Service. Please note: We are not obligated to provide you with a provider. We are not liable for anything your provider does or does not do. We are not a healthcare provider and do not practice medicine, dentistry, furnish health care, or make medical judgments.

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