Provider Manual. The MCO must develop, distribute, and maintain a provider manual. The MCO must submit a copy of the provider manual to BMS by July 1st of each Contract year. BMS reserves the right to review and approve the MCO’s provider manual. In addition, the MCO must document the approval of the provider manual by the MCO Administrator and Medical Director and must maintain documentation that verifies that the provider manual is reviewed at least annually. The MCO must ensure that each provider (individual or group which submits claim and encounter data) is issued a printed or electronic copy of the provider manual during the contracting process with the MCO. The MCO must provide a copy of the provider manual to a provider upon request. When there are BMS policy or program changes or MCO procedure or service site changes, notification must be sent to the affected providers at least thirty (30) calendar days before the intended effective date of the change. The MCO must publish and keep current its provider manual on the MCO website.
Appears in 3 contracts
Samples: Model Purchase of Service Provider Agreement, Service Provider Agreement, Model Purchase of Service Provider Agreement
Provider Manual. The MCO must develop, distribute, and maintain a provider manual. The MCO must submit a copy of the provider manual to BMS by July 1st of each Contract year. BMS reserves the right to review and approve the MCO’s provider manual. In addition, the MCO must document the approval of the provider manual by the MCO Administrator and Medical Director and must maintain documentation that verifies that the provider manual is reviewed at least annually. The MCO must ensure that each provider (individual or group which submits claim and encounter data) is issued a printed or electronic copy of the provider manual during the contracting process with the MCO. The MCO must provide a copy of the provider manual to a provider upon request. When there are BMS policy or program changes or MCO procedure or service site changes, notification must be sent to the affected providers at least thirty (30) calendar days before the intended effective date of the change. The MCO must publish and keep current its provider manual on the MCO websitewebsite as specified in Article III, Section 3.4.5 of this contract.
Appears in 3 contracts
Samples: Service Provider Agreement, Service Provider Agreement, Service Provider Agreement
Provider Manual. The MCO must develop, distribute, distribute and maintain a provider manual. The MCO must submit a copy of the provider manual to BMS DHHR as part of the MCO’s initial readiness review during implementation and annually by July 1st of each Contract year. BMS reserves the right to review and approve the MCO’s provider manual. In addition, the MCO must document the approval of the provider manual by the MCO Administrator and Medical Director and must maintain documentation that verifies that the provider manual is reviewed at least annually. The MCO must ensure that each provider (individual or group which submits claim and encounter data) is issued a printed or electronic copy of the provider manual during the contracting process with the MCO. The MCO must provide a copy of the provider manual to a provider upon request. When there are BMS Department policy or program changes or MCO procedure or service site changes, notification must be sent to the affected providers at least thirty (30) calendar days before the intended effective date of the change. The MCO must publish and keep current its provider manual on the MCO website.
Appears in 2 contracts
Samples: dhhr.wv.gov, dhhr.wv.gov
