Provider and Pharmacy Directory Sample Clauses

Provider and Pharmacy Directory. The Contractor shall make its Provider and Pharmacy Directory available to Providers via the Contractor’s web-portal.
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Provider and Pharmacy Directory. The ICO shall make its Provider and Pharmacy Directory available to providers via the ICO’s web-portal. Upon request, the ICO must be able to provide a paper copy to providers. The ICO shall educate providers through a variety of means including, but not limited to, provider alerts or similar written issuances, about their legal obligations under State and Federal law to communicate with Enrollees and Potential Enrollees with limited English proficiency, including the provision of interpreter services, and the resources available to help providers comply with those obligations. All such written communications shall be subject to review at MDHHS’s and CMS’ discretion. Subcontracting Requirements The ICO remains fully responsible for meeting all of the terms and requirements of the Contract regardless of whether the ICO subcontracts for performance of any Contract responsibility. The ICO shall require each First Tier, Downstream or Related Entity to meet all terms and requirements of the Contract that are applicable to such First Tier, Downstream or Related Entity. No subcontract will operate to relieve the ICO of its legal responsibilities under the Contract. The ICO is responsible for the satisfactory performance and adequate oversight of its First Tier, Downstream and Related Entities. First Tier, Downstream and Related Entities are required to meet the same federal and State financial and program reporting requirements as the ICO. The ICO is required to evaluate any potential First Tier, Downstream or Related Entity prior to delegation, pursuant to 42 C.F.R. § 438.330. Additional information about subcontracting requirements is contained in Appendix C. The ICO must establish contracts and other written agreements between the ICO and First Tier, Downstream and Related Entities for Covered Services not delivered directly by the ICO or its employees; The ICO must require that First Tier, Downstream and Related Entities afford Enrollees the opportunity and assistance with filing a Grievance, Appeal, or State Fair Hearing, and require procedures and timeframes for doing so, as well as the rules for representation at hearing; and that First Tier, Downstream and Related Entities must permit an Enrollee to request continuation of benefits if the Enrollee files an Appeal or a request for a State Fair Hearing within specified timeframes; and the ICO must provide the toll-free numbers to file oral Grievances and Appea...
Sample 1
Provider and Pharmacy Directory. The CICO shall make its Provider and Pharmacy Directory available to Providers via the CICO’s web-portal. The CICO shall educate Providers through a variety of means including, but not limited to, Provider alerts or similar written issuances, about their legal obligations under state and federal law to communicate with Enrollees and Eligible Beneficiaries with limited English proficiency, including the provision of interpreter services, and the resources available to help Providers comply with those obligations. All such written communications shall be subject to review at SCDHHS’ and CMS’ discretion. Subcontracting Requirements The CICO remains fully responsible for meeting all of the terms and requirements of the Contract regardless of whether the CICO subcontracts for performance of any Contract responsibility. The CICO shall require each First Tier, Downstream, or Related Entity to meet all terms and requirements of the Contract that are applicable to such First Tier, Downstream, or Related Entity. No subcontract will operate to relieve the CICO of its legal responsibilities under the Contract. The CICO is responsible for the satisfactory performance and adequate oversight of its First Tier, Downstream, and Related Entities. First Tier, Downstream, and Related Entities are required to meet the same federal and state financial and program reporting requirements as the CICO. The CICO is required to evaluate any potential CICO prior to delegation, pursuant to 42 C.F.R. § 438.230. Additional information about subcontracting requirements is contained in Appendix E.. The CICO must establish contracts and other written agreements between the CICO and First Tier, Downstream, and Related Entities for Covered Services not delivered directly by the CICO or its employees.
Sample 1
Provider and Pharmacy Directory. The ICO shall make its Provider and Pharmacy Directory available to providers via the ICO’s web-portal. Upon request, the ICO must be able to provide a paper copy to providers.
Sample 1

Related to Provider and Pharmacy Directory

  • Provider Directory a. The Contractor shall make available in electronic form and, upon request, in paper form, the following information about its network providers:

  • Provider Network The Panel of health service Providers with which the Contractor contracts for the provision of covered services to Members and Out-of-network Providers administering services to Members.

  • Provider Services The Contractor’s system shall collect, process, and maintain current and historical data on program providers. This information shall be accessible to all parts of the MCMIS for editing and reporting.

  • Provider Manual The Provider Manual shall be a comprehensive online reference tool for the Provider and staff regarding, but not limited to, administrative, prior authorization, and referral processes, claims and encounter submission processes, continuity of care requirements, and plan benefits. The Provider Manual shall also address topics such as clinical practice guidelines, availability and access standards, care management programs and Enrollee rights.

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

  • Contract for Professional Services of Physicians Optometrists, and Registered Nurses In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government Code, Section 2254.008(a)(2) is applicable to this Contract, Contractor affirms that it possesses the necessary occupational licenses and experience.

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

  • Credentialing The Provider will maintain written documentation confirming that each individual providing services under this agreement has and maintains the requisite credentials. Any change in status regarding any credentialing requirements must be reported in writing, by the Provider to the Department's Credentialing Contracted Agent, within thirty days.

  • Credentials The names and credentials of the individuals who: (1) designed the statistical sampling procedures and the review methodology utilized for the Claims Review and (2) performed the Claims Review.

  • Routing for Operator Services and Directory Assistance Traffic For a Verizon Telecommunications Service dial tone line purchased by CBB for resale pursuant to the Resale Attachment, upon request by CBB, Verizon will establish an arrangement that will permit CBB to route the CBB Customer’s calls for operator and directory assistance services to a provider of operator and directory assistance services selected by CBB. Verizon will provide this routing arrangement in accordance with, but only to the extent required by, Applicable Law. Verizon will provide this routing arrangement pursuant to an appropriate written request submitted by CBB and a mutually agreed-upon schedule. This routing arrangement will be implemented at CBB's expense, with charges determined on an individual case basis. In addition to charges for initially establishing the routing arrangement, CBB will be responsible for ongoing monthly and/or usage charges for the routing arrangement. CBB shall arrange, at its own expense, the trunking and other facilities required to transport traffic to CBB’s selected provider of operator and directory assistance services.

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