Common use of Provider Training Clause in Contracts

Provider Training. The Contractor must: 1. Inform its Provider Network about the program, including all Covered Services contained in Appendix A; 2. Educate its Provider Network about its responsibilities for the integration and coordination of Covered Services through the provision of a Provider-training curriculum, flow charts, and other written materials to enhance coordination and linkage; 3. Inform its Provider Network about the procedures and timeframes for Enrollee Complaints and Enrollee Appeals; 4. Develop and provide continuing education programs for members of the Provider Network, including but not limited to: a. Identification and management of depression, alcohol abuse, and Alzheimer’s disease; b. Identification and treatment of incontinence; c. Preventing falls; d. Identification of abuse and neglect of elderly individuals; and e. Coordination of care within the Provider Network, including instructions regarding policies and procedures for maintaining the Centralized Enrollee Record. 5. Instruct and assist the Providers in the Contractor’s Provider Network in the process and need for verifying each Enrollee’s MassHealth eligibility and enrollment in MassHealth prior to providing any services, and at each point of service, through EOHHS’s electronic on-line Eligibility Verification System (EVS). The Contractor and its Providers shall not require such verification prior to providing Emergency Services and without resulting in discrimination against the Enrollee.

Provider Training. The Contractor must: 1. Inform its Provider Network about the program, including all Covered Services contained in Appendix A; 2. Educate its Provider Network about its responsibilities for the integration and coordination of Covered Services through the provision of a Provider-training curriculum, flow charts, and other written materials to enhance coordination and linkage; 3. Inform its Provider Network about the procedures and timeframes for Enrollee Complaints and Enrollee Appeals; 4. Develop and provide continuing education programs for members of the Provider Network, including but not limited to: a. Identification and management of depression, alcohol abuse, and Alzheimer’s disease; b. Identification and treatment of incontinence; c. Preventing falls; d. Identification of abuse and neglect of elderly individuals; and e. Coordination of care within the Provider Network, including instructions regarding policies and procedures for maintaining the Centralized Enrollee Record. 5. Instruct and assist the Providers in the Contractor’s its Provider Network in the process and need for verifying each Enrollee’s MassHealth eligibility and enrollment in MassHealth prior to providing any services, and at each point of service, through EOHHS’s electronic on-line from the Eligibility Verification System (EVS) before providing services (except for services for Emergency Conditions). The Contractor and its Providers shall not require such verification prior to providing Emergency Services and , without resulting in discrimination against the Enrollee.