Network adequacy definition

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

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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.

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

Examples of Network adequacy in a sentence

• The Contractor must comply with federal regulations regarding Provider Network adequacy as stated in 42 C.F.R. §§ 438.68, 438.206, 438.207; and must comply with state regulations regarding reconsideration of inclusion per Miss.

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

• Access (as it pertains to external quality review) – The timely use of services to achieve optimal outcomes, as evidenced by the Contractor successfully demonstrating and reporting on outcome information for the availability and timeliness elements defined under 42 CFR 438.68 (Network adequacy standards) and 42 CFR 438.206 (Availability of services).

• Access: Per 42 CFR §438.320, as it pertains to external quality review, “access” means the timely use of services to achieve optimal outcomes, as evidenced by the HMO successfully demonstrating and reporting on outcome information for the availability and timeliness elements defined in 42 CFR §438.68 (Network adequacy standards) and 42 CFR §438.206 (Availability of services).

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

More Definitions of Network adequacy

Network adequacy means the adequacy of the provider

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 the adequacy 1of1 the provider network with respect to the scope and type of health care benefits provided by the managed care plan, the geographic service area covered by the provider network, and access to 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. (42 C.F.R § 438.68, § 438.14(b) and 438.206).