Common use of Initial Contact, General Orientation Clause in Contracts

Initial Contact, General Orientation. (A) During the initial contact, the Contractor’s representative shall provide, at minimum, the following information to the Enrollee or Potential Enrollee: (1) specific written and oral instructions on the use of the Contractor’s Covered Services and procedures; (2) explain that to the Enrollee that his/her Primary Care services, medication management, and mental health concerns will be provided at the Contractor’s Clinic; (3) explain the Contractor’s case management and care coordination model; (4) introduce the Enrollee to his/her assigned case manager; (5) provide each Enrollee a HOME Member Handbook, Provider Directory, and ▇▇▇▇ ▇▇▇▇▇ phone list; (6) availability and accessibility of all Covered Services, including the availability of family planning services and that the Enrollee may obtain family planning services from Non-Network Providers; (7) the rights and responsibilities of the Enrollee under the Contractor’s Health Plan, including the right to file a Grievance or an Appeal and how to file a Grievance or an Appeal; and (8) the right to terminate enrollment with the Contractor’s Health Plan. (B) The Contractor shall ensure that Enrollees are provided interpreters, Telecommunication Device for the Deaf (TDD), and other auxiliary aids to ensure that Enrollees understand their rights and responsibilities.

Initial Contact, General Orientation. (A) Within 30 days of Enrollment, the Contractor shall conduct an in-person welcome intake visit with the Enrollee. During the initial contact, welcome intake visit the Contractor’s representative shall provide, at minimum, the following information to the Enrollee or Potential EnrolleeContractor shall: (1) give specific written and oral instructions on how the use of Enrollee may obtain Covered Service and the Contractor’s Covered Services and proceduresprocedures for obtaining Coverd Services; (2) explain that to the Enrollee that his/her Primary Care primary care services, medication management, and mental health concerns will be provided at the Contractor’s Clinic; (3) explain the Contractor’s case management and care coordination model; (4) introduce the Enrollee to his/her assigned case manager; (5) provide each Enrollee a HOME Member Handbook, Provider Directory, and ▇▇▇▇ ▇▇▇▇▇ phone list; (6) explain the availability and accessibility of all Covered Services, including the availability of family planning services and that the Enrollee may obtain family planning services from Non-Network Providers; (7) explain the rights Rights and responsibilities Responsibilities of the Enrollee under the Contractor’s Health Plan, including the right to file a Grievance or an Appeal and how to file a Grievance or an AppealGrievance; and (8) explain the right to terminate enrollment with the Contractor’s Health Plan. (B) The Contractor shall ensure that Enrollees are provided interpreters, Telecommunication Device for the Deaf (TDD), and other auxiliary aids to ensure that Enrollees understand their rights and responsibilities.