Network adequacy definition

Network adequacy means a network of providers for the Contractor that is sufficient in numbers and types of providers/facilities to ensure that all services are accessible to Individuals in this Contract and within Available Resources. Non-Participating Provider

Network adequacy means access to services by measure of distance, time, and average length of

Network adequacy means the adequacy of the provider

Examples of Network adequacy in a sentence

• Network adequacy may emerge as a compliance challenge if plans are using more restrictive processes, strategies, standards, or other factors for including MH/SUD providers in their networks compared with M/S providers.

• Network adequacy assurance submitted by plan [ Required for MCO/PIHP/PAHP] The State will require the MCO to annually submit to the State assurances that they have adequate networks with regard to PCP/Specialist Capacity.

• A comprehensive plan for Network adequacy that includes a list of all contracted and credentialed Providers, in a format approved by HHSC.

• Network adequacy - required disclosures - balance12 billing - rules - legislative declaration - definitions.

• Network adequacy standardsNon-compliance of dental benefit managersIn accordance with 42 C.F.R. § 438.604, the MCO or DBM will submit documentation for which OHCA will base its certification to CMS that the MCO or DBM has complied with requirements for availability and accessibility of services, including health professional shortage areas and adequacy of the MCO's or DBM's network, as set forth in 42 C.F.R. §§ 438.206, 438.14 and 438.68.(a) Failure to comply.

More Definitions of Network adequacy

Network adequacy means a Medicaid beneficiaries' ability

Network adequacy means the adequacy 1of1 the provider

Network adequacy means the adequacy of a

Network adequacy means access to services by measure of distance, time, and average length of referral to scheduled visit.

Network adequacy means the adequacy of the provider network with respect to the scope and type of health care benefits provided by a carrier, the geographic service area covered by the provider network, and access to hospital based and medical specialists pursuant to the standards in the regulations promulgated pursuant to section 19 of P.L.1997, c.192 (C.26:2S-18) and in the existing contract between a managed care organization and the Division of Medical Assistance and Health Services in the Department of Human Services.

Network adequacy means the adequacy the provider network

Network adequacy means a network of providers for the Contractor that is sufficient in numbers and types of providers/facilities to ensure that all services are accessible to Enrollees without unreasonable delay. Adequacy is determined by a number of factors including, but not limited to provider/patient ratios, geographic accessibility and travel distance.