Common use of Provider Profiling Clause in Contracts

Provider Profiling. ‌ 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. a. Developing provider-specific reports that include a multi-dimensional assessment of a provider’s performance using clinical, administrative, and Enrollee satisfaction indicators of care that are accurate, measurable, and relevant to the enrolled population;