Common use of New Member Orientation Clause in Contracts

New Member Orientation. The PH-MCO must have written policies and procedures for new Members or a written orientation plan or program that includes: • Orienting new Members to their benefits (e.g., prenatal care, dental care, and specialty care), • Educational and preventative care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • Education of members on how they can report suspected fraud, waste and abuse, • The proper use of the PH-MCO identification card and the Department's ACCESS Card, • The role of the PCP, • What to do in an emergency or urgent medical situation, • How to utilize services in other circumstances, • How to request information from the PH-MCO • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, and • Information on the existence and function of the SNU and how to contact it, if necessary. The PH-MCO must obtain the Department advance written approval of these policies and procedures. The PH-MCO is prohibited from contacting a potential Member who is identified on the Daily Membership File with an automatic assignment indicator (either an "A" auto assigned or "M" Member assigned) until five (5) Business Days before the effective date of the Member’s Enrollment unless it is the PH-MCO’s responsibility under this Agreement; or at the request of the Department.

New Member Orientation. The PH-MCO must have written policies and procedures for new Members or a written orientation plan or program that includes: • Orienting new Members to their benefits (e.g., prenatal care, dental care, and specialty care), • Educational and preventative care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • Education of members on how they can report suspected fraud, waste and abuse, • The proper use of the PH-MCO identification card and the Department's ACCESS Card, • The role of the PCP, • What to do in an emergency or urgent medical situation, • How to utilize services in other circumstances, • How to request information from the PH-MCO • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, and • Information on the existence and function of the SNU and how to contact it, if necessary. The PH-MCO must obtain the Department advance written approval of these policies and procedures. The PH-MCO is prohibited from contacting a potential Member who is identified on the Daily Membership File with an automatic assignment indicator (either an "A" auto assigned or "M" Member assigned) until five (5) Business Days before the effective date of the Member’s 's Enrollment unless it is the PH-MCO’s 's responsibility under this Agreement; or at the request of the Department.