TPR SUBSYSTEM. HMO's third party recovery system must have the following capabilities and capacities:
TPR SUBSYSTEM. 10.2 SYSTEM-WIDE FUNCTIONS HMO MIS system must include functions and/or features which must apply across all subsystems as follows:
TPR SUBSYSTEM. 105 10.11 YEAR 2000 (Y2K) COMPLIANCE....................................................105 ARTICLE XI QUALITY ASSURANCE AND QUALITY IMPROVEMENT PROGRAM..................106 11.1 QUALITY IMPROVEMENT PROGRAM (QIP) SYSTEM......................................106 11.2 WRITTEN QIP PLAN..............................................................106 11.3 QIP SUBCONTRACTING............................................................106 11.4 ACCREDITATION.................................................................106 11.5 BEHAVIORAL HEALTH INTEGRATION INTO QIP........................................106 11.6 QIP REPORTING REQUIREMENTS....................................................107 ARTICLE XII REPORTING REQUIREMENTS.............................................107
TPR SUBSYSTEM. 96 10.11 YEAR 2000 (Y2K) COMPLIANCE........................................ 96 ARTICLE XI QUALITY ASSURANCE AND QUALITY IMPROVEMENT PROGRAM........ 97
TPR SUBSYSTEM. 10.2 SYSTEM-WIDE FUNCTIONS --------------------- HMO MIS system must include functions and/or features which must apply across all subsystems as follows: El Paso Service Area HMO Contract
TPR SUBSYSTEM. HMO's third party recovery system must have the following capabilities and capacities: 1999 Renewal Contract Bexar Service Area August 9, 1999
TPR SUBSYSTEM. 98 ARTICLE XI QUALITY ASSURANCE AND QUALITY IMPROVEMENT PROGRAM ...........98 11.1 QUALITY IMPROVEMENT PROGRAM (QIP) SYSTEM ..............................98 11.2 WRITTEN QIP PLAN ......................................................98 11.3 QIP SUBCONTRACTING ....................................................98 11.4 ACCREDITATION .........................................................98
TPR SUBSYSTEM. 126 10.12 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) COMPLIANCE.................................. 126 ARTICLE 11 QUALITY ASSURANCE AND QUALITY IMPROVEMENT PROGRAM ................................................. 127 11.1 QUALITY ASSESSMENT AND PERFORMANCE IMPROVEMENT PROGRAM .................................................. 127 11.2 WRITTEN QIP PLAN ........................................................................................ 127 11.3 QIP SUBCONTRACTING ...................................................................................... 127 11.4 ACCREDITATION............................................................................................ 127 11.5 BEHAVIORAL HEALTH INTEGRATION INTO QIP................................................................... 128 11.6
TPR SUBSYSTEM. 10.1.9 HMO must submit a joint interface plan (JIP) in a format specified by HHSC. The JIP will include required information on all contractor interfaces that support the Medicaid Information Systems. The submission of the JIP will be in accordance with the HMO's Readiness Review and submitted prior to any major system changes thereafter.
TPR SUBSYSTEM. 91 10.11 YEAR 2000 COMPLIANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 ARTICLE XI QUALITY ASSURANCE AND QUALITY IMPROVEMENT PROGRAM . . . . . . . . . . . . . . . . . . . . . . . . . . 92 11.1 QUALITY IMPROVEMENT PROGRAM (QIP) SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 11.2 WRITTEN QIP PLAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 11.3 QIP SUBCONTRACTING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 11.4 ACCREDITATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Dallas Service Area Contract 4
