Provider Profiling. The HMO must conduct PCP and other Provider profiling activities at least annually. As part of its QAPI Program, the HMO must describe the methodology it uses to identify which and how many Providers to profile and to identify measures to use for profiling such Providers. Provider profiling activities must include, but not be limited to:
Provider Profiling. The MCO must conduct PCP and other Provider profiling activities at least annually. As part of its QAPI Program, the MCO must describe the methodology it uses to identify which and how many Providers to profile and to identify measures to use for profiling such Providers. Provider profiling activities must include, without limitation:
Provider Profiling. 2.7.3.1. The Contractor must conduct profiling activities for PCPs, Behavioral Health Providers, LTSS providers, dental providers, vision providers and, as directed by EOHHS, specialty providers, at least annually. As part of its quality activities, the Contractor must document the methodology it uses to identify which and how many providers to profile and to identify measures to use for profiling such providers.
Provider Profiling. The OVHA shall conduct provider profiling activities, including producing monthly information on enrollment, service encounters, costs, reimbursements, and outcomes for all health services provided to Global Commitment to Health Waiver enrollees through its subcontracted Departments. Information used in provider profiling will include data from all providers of health services within the subcontracted Departments, and will provide for the development of standard comparison reports and ad hoc reports as needed. Standard and ad-hoc reports shall be made available to the subcontracted Departments.
Provider Profiling. The Contractor shall conduct PCD Provider and other Participating Provider profiling activities at least quarterly. As part of its QAPI Program, the Contractor shall describe the methodology it uses to identify which and how many Participating Providers to profile and to identify measures to use for profiling such Providers. Provider profiling activities shall include, without limitation: • Developing PCD Provider and other Provider-specific reports that include a multi-dimensional assessment of a PCD Provider or other Participating Provider’s performance using clinical, administrative and Dental Health Plan Enrollee satisfaction indicators of care that are accurate, measurable, and relevant to the enrolled population; • Establishing PCD Provider, other Participating Provider, group, service area, or regional benchmarks for areas profiled, where applicable; and • Providing feedback to individual PCD Providers and other Participating Providers regarding the results of their performance and the overall performance of the Contractor’s Participating Provider network.
Provider Profiling. 2.8.7.1. The Contractor must conduct profiling activities for PCPs, behavioral health Providers, LTSS providers, and, as directed by DMAS, specialty providers, at least annually. As part of its quality activities, the Contractor must submit to DMAS by December 31 of each year for review and approval prior to its use the methodology to identify which and how many providers to profile and to identify measures to use for profiling such providers.
Provider Profiling. The HMO must conduct PCP and other Provider profiling activities at least annually. As part of its QAPI Program, the HMO must describe the methodology it uses to identify which and how many Providers to profile and to identify measures to use for profiling such Providers. Provider profiling activities must include, but not be limited to: 1 Developing PCP and Provider-specific reports that include a multi-dimensional assessment of a PCP or Provider’s performance using clinical, administrative, and Member satisfaction indicators of care that are accurate, measurable, and relevant to the enrolled population; 2 Establishing PCP, Provider, group, Service Area or regional Benchmarks for areas profiled, where applicable, including STAR, STAR+PLUS, CHIP and CHIP Perinatal Program-specific Benchmarks, where appropriate; and 3 Providing feedback to individual PCPs and Providers regarding the results of their performance and the overall performance of the Provider Network.
Provider Profiling. DVHA in collaboration with its IGA partners shall conduct periodic provider profiling activities, including producing information on enrollment, service claims, costs, reimbursements, and outcomes for all health services provided to Global Commitment to Health Waiver enrollees. Information used in provider profiling will include data from all providers of health services within the IGA partner Departments.
