Tracking Slot Availability. The Contractor shall identify the maximum number of members it is able to enroll and maintain under this Contract. The Contractor agrees to provide services to members up to the maximum enrollment limits indicated for the Contractor in the Policy and Procedure Guide. SCDHHS reserves the right to approve or deny the maximum number of members to be enrolled in the Contractor's plan based on the determination of the adequacy of network capacity by SCDHHS. On a monthly basis and consistent with the Policy and Procedure Guide, the Contractor will update its maximum enrollment by county numbers. The Contractor shall track slot availability and notify SCDHHS’ Enrollment Broker when filled slots are near capacity. Upon notification, SCDHHS or its designee will not assign any other eligibles to that plan without consulting the Contractor first. SCDHHS will notify the Contractor when the Contractor's enrollment levels are maximized and will not enroll eligibles when there are no more slots available.
Appears in 1 contract
Sources: Contract for Medical Services
Tracking Slot Availability. The Contractor shall identify the maximum number of members it is able to enroll and maintain under this Contract. The Contractor agrees to provide services to members up to the maximum enrollment limits indicated for the Contractor in the Policy and Procedure Guide. SCDHHS reserves the right to approve or deny the maximum number of members to be enrolled in the Contractor's plan based on the determination of the adequacy of network capacity by SCDHHS. On a monthly basis and consistent with the Policy and Procedure Guide, the Contractor will is to update its the maximum enrollment by county numberscounty. The Contractor shall track slot availability and notify SCDHHS’ Enrollment Broker when filled slots are near capacity. Upon notification, SCDHHS or its designee will not assign any other eligibles to that plan without consulting the Contractor first. SCDHHS will notify the Contractor when the Contractor's enrollment levels are maximized and will not enroll eligibles when there are no more slots available.
Appears in 1 contract
Sources: Contract for Medical Services