Common use of Provider Services Clause in Contracts

Provider Services. ‌ Contractor shall establish and monitor performance standards for provider service functions. As part of its Provider Services function, Contractor shall have an ongoing program of provider education concerning the benefits and the needs of the member population covered under this Attachment. The provider education program shall include a quarterly provider newsletter and shall communicate, at least annually, changes in benefits, member’s rights and responsibilities. Contractor will have a Provider Services a toll-free telephone line that operates at least during normal business hours to provide assistance to providers concerning: • RIte Smiles member eligibility status, • Covered benefits, • Claims submission and payment procedures, • Prior authorization and referral, where allowable under State Medicaid policy, • Provider complaints, • Care management and • Cultural Competency Contractor will make available a Provider Relations Representative who will provide face-to- face, facility-based assistance and training when necessary. The Provider Relations Representative will be based either in Rhode Island or in New England and must be readily accessible to meet the needs of the RIte Smiles providers in a timely manner. Contractor shall require providers to report any changes in address or telephone numbers at least thirty (30) days prior to the change occurring.

Provider Services. ‌ Contractor shall establish and monitor performance standards for provider service functions. As part of its Provider Services function, Contractor shall have an ongoing program of provider education concerning the benefits and the needs of the member population covered under this Attachment. The provider education program shall include a quarterly provider newsletter and shall communicate, at least annually, changes in benefits, member’s rights and responsibilities. Contractor will have a Provider Services a toll-free telephone line that operates at least during normal business hours to provide assistance to providers concerning: • RIte Smiles member eligibility status, • Covered benefits, • Claims submission and payment procedures, • Prior authorization and referral, where allowable under State Medicaid policy, • Provider complaints, • Care management and • Cultural Competency Contractor will make available a Provider Relations Representative who will provide face-face- to- face, facility-based assistance and training when necessary. The Provider Relations Representative will be based either in Rhode Island or in New England and must be readily accessible to meet the needs of the RIte Smiles providers in a timely manner. Contractor shall require providers to report any changes in address or telephone numbers at least thirty (30) days prior to the change occurring.

Provider Services. ‌ Contractor shall establish and monitor performance standards for provider service functions. As part of its Provider Services function, Contractor shall have an ongoing program of provider education concerning the benefits and the needs of the member population covered under this Attachment. The provider education program shall include a quarterly provider newsletter and shall communicate, at least annually, changes in benefits, member’s rights and responsibilities. Contractor will have a Provider Services a toll-free telephone line that operates at least during normal business hours to provide assistance to providers concerning: •  RIte Smiles member eligibility status, •  Covered benefits, •  Claims submission and payment procedures, •  Prior authorization and referral, where allowable under State Medicaid policy, •  Provider complaints, •  Care management and •  Cultural Competency Contractor will make available a Provider Relations Representative who will provide face-to- face, facility-based assistance and training when necessary. The Provider Relations Representative will be based either in Rhode Island or in New England and must be readily accessible to meet the needs of the RIte Smiles providers in a timely manner. Contractor shall require providers to report any changes in address or telephone numbers at least thirty (30) days prior to the change occurring.