ELEMENT A definition
Examples of ELEMENT A in a sentence
ELEMENT A: Information for UM Decision Making The organization has a written description that identifies the information that is needed to support UM decision making in place for at least 12 months.
ELEMENT A: Written Program Description The organization’s UM program description includes the following factors: 1 program structure ü 2 behavioral health care aspects of the program ü 4 involvement of a designated behavioral health care practitioner in the implementation of the behavioral health care aspects of the UM program ü ELEMENT B: Physician Involvement A senior physician is actively involved in implementing the organization’s UM program.
ELEMENT A: Licensed Health Professionals The organization has written procedures: 1 requiring appropriately licensed professionals to supervise all medical necessity decisions ü 2 specifying the type of personnel responsible for each level of UM decision making.
ELEMENT A: Policies and Procedures The organization’s policies and procedures require: ELEMENT C: Organization’s Authorized Representative The organization covers emergency services approved by an authorized representative.
ELEMENT A: Distribution of Rights Statement to Members and Practitioners The organization distributes its members’ rights and responsibilities statement to: 1 existing members ü 2 new members ü 3 existing practitioners ü 4 new practitioners.
ELEMENT A: Written Delegation Agreement There is a mutually agreed-upon document that describes all delegated activities.
ELEMENT A: Policies and Procedures The organization’s policies and procedures for pharmaceutical management include: 1 the criteria used to adopt pharmaceutical management procedures ü 2 a process that uses clinical evidence from appropriate external organizations.
ELEMENT A: Distribution of New Guidelines The organization communicates new guidelines to the appropriate existing practitioners.
ELEMENT A: Service Improvements The organization demonstrates two service improvements, each of which is one of the following types: 1 significant improvement in a CAHPS® 4.0H composite or rating result or question ü 2 meaningful improvement in a QI service activity not using the CAHPS® 4.0H results in an area of service identified as an opportunity and relevant to the organization’s population.
The organization has a process that ensures for ensuring that the offices of all primary care practitioners, obstetricians/gynecologists and high volume behavioral health care practitioners meet the organization’s office site standards ü ELEMENT A: Performance Standards and Thresholds The organization: ü 1 sets standards and performance thresholds for office site criteria .