Provider Network Information. The Enrollment Packet shall include information on where to find information about the Contractor’s provider network. Additionally, the Contractor shall include a current provider directory and/or information on how to find a network provider near the member’s residence on-line and via the Member Helpline. In accordance with 42 CFR 438.10(h), the provider directory must include the following information: ▪ Primary care physicians, specialists and hospitals; ▪ Name, location and telephone number of providers; ▪ Identification of non-English language spoken by providers; ▪ Provider web sites, if applicable; ▪ If the provider has accommodations for people with physical disabilities; ▪ Pharmacies and behavioral health providers; ▪ Contact information for all brokers contracted with the MCE; and ▪ Identification of providers that are not accepting new patients. A printed copy of the provider directory must also be available to members and FSSA upon request. The Contractor must include the aforementioned provider network information, by county, on its member website. The information must be updated, at minimum, every two (2) weeks. Network provider information must be available to print from a remote user location.
Provider Network Information. The MCO will submit to the STATE a complete listing of its provider network in accordance with the specifications outlined in the STATE’s provider network template posted on the STATE’s website. The MCO will submit its entire provider network on the fifth of every month to the STATE’s provider data repository. The MCO will work with the STATE to ensure that its monthly provider network data submission is complete, accurate, and timely and will resolve any issues necessary to successfully submit the data.
Provider Network Information. The Enrollment Packet shall include information on where to find information about the Contractor’s provider network. Additionally, the Contractor shall include a current provider directory and/or information on how to find a network provider near the member’s residence on-line and via the Member Helpline. In accordance with 42 CFR 438.10(h), the provider directory must include the following information for all network providers, including but not limited to, all types of PMPs, specialists, hospitals, pharmacies, behavioral health providers: • Name, group affiliation, location, telephone number and specialty of providers; • Whether PMPs will accept new enrollees; • Cultural and linguistic capabilities, including languages spoken by the provider or the provider’s office personnel; • Provider web sites, if applicable; • If the provider has accommodations for people with physical disabilities, including offices, exam rooms and equipment; • Pharmacies and behavioral health providers; and • Contact information for all brokers contracted with the MCE; and Identification of providers that are not accepting new patients. A printed copy of the provider directory must also be available to members and FSSA upon request. The Contractor shall include the aforementioned provider network information in an FSSA-approved format (compliant with Section 508 of the US Rehabilitation Act) on its member website. The Contractor shall list provider network information by county on the Contractor’s website and update the information every two (2) weeks. As required by 42 CFR 438.10(h)(3)(i)(A) – (B) and 42 CFR 438.10(h)(3)(ii), provider network information on the Contractor’s website must be updated no later than thirty (30) calendar days after the Contractor receives updated provider information. Network provider information shall be available to print from a remote user location and in a machine-readable file and format as specified by the Secretary per 42 CFR 457.1207 and 42 CFR 438.10(h)(4). Paper provider network directories must be updated at least quarterly.
Provider Network Information. The Contractor shall submit a quarterly Provider Enrollment File report that includes information on all providers of the SNP Plan’s covered health benefits. This includes but is not limited to, PCPs, physician specialists, hospitals and home health agencies. The report shall include contract providers as well as all non-contract providers with whom the Contractor has a relationship. This list need not include retail pharmacies. The Contractor shall submit this report by the 15th of the following months: February, May, August and November. Each quarterly Provider Enrollment File shall include information on all providers of health benefits and shall provide a complete replacement for any previous Provider Enrollment Files submission. Any changes in the provider’s contract status from the previous submission shall be indicated in the file generated in the quarter the change became effective and shall be submitted in the next quarterly file. The provider network information shall be updated regularly as specified by TennCare. Contractor will contact TennCare’s Office of Provider Networks for the proper format for the submission. The Contractor shall develop a network of providers that specifically targets overlap of providers in its network with providers that are also enrolled with one or more TennCare MCOs in order to ensure seamless access to care for FBDE members across the Medicare and Medicaid programs.
Provider Network Information i. The MCOP must submit provider network information, including provider additions and deletions, to ODM in the format and at the frequency specified by ODM to ODM's provider network management system.
Provider Network Information. (1) The MCO must submit to MDH annually by April 1st of the Contract Year a complete list of Participating Providers, including name, specialty, and address, in a format specified and provided by MDH. For MSHO, providers of Medicare and Medicaid services must be included. This requirement excludes pharmacies, transportation providers, and interpreters. The STATE will obtain the participating provider list from MDH.
Provider Network Information. 1. The Contractor shall submit a quarterly Provider Enrollment File report that includes information on all providers of the Plan's covered health benefits. This includes but is not limited to, PCPs, physician specialists, hospitals, and home health agencies. The report shall include contract providers as well as all non-contract providers with whom the Contractor has a relationship. This list need not include retail pharmacies. The Contractor shall submit this report by the 15th of the following months: February, May, August and November. Each quarterly Provider Enrollment File shall include information on all providers of health benefits and shall provide a complete replacement for any previous Provider Enrollment Files submission. Any changes in the provider's contract status from the previous submission shall be indicated in the file generated in the quarter the change became effective and shall be submitted in the next quarterly file. The provider network information shall be updated regularly as specified by TennCare. The Contractor shall contact TennCare's Office of Provider Networks for the proper format for the submission.
Provider Network Information. (1) The MCO will submit to the STATE a complete listing of its Provider network in accordance with the specifications outlined in the STATE’s provider network template posted on the STATE’s website. The MCO will submit its entire Provider network on the fifth of every month to the STATE’s provider data repository. The MCO will work with the STATE to ensure that its monthly Provider network data submission is complete, accurate, and timely and will resolve any issues necessary to successfully submit the data. For MSHO, contracted Home and Community-Based Services, and Nursing Facility providers; and providers of Medicare and Medicaid services must be included.
Provider Network Information. The Enrollment Packet shall include information on where to find information about the Contractor’s provider network. Additionally, the Contractor shall include a current provider directory and/or information on how to find a network provider near the member’s residence on-line and via the Member Helpline. In accordance with 42 CFR 438.10(h), the provider directory must include the following information: ▪ Primary care physicians, specialists and hospitals; ▪ Name, location and telephone number of providers; ▪ Identification of non-English language spoken by providers; ▪ Provider web sites, if applicable; ▪ If the provider has accommodations for people with physical disabilities; ▪ Pharmacies and behavioral health providers; ▪ Contact information for all brokers contracted with the MCE; and ▪ Identification of providers that are not accepting new patients
Provider Network Information. The Enrollment Packet shall include information on where to find information about the EXHIBIT 1 SCOPE OF WORK – HOOSIER HEALTHWISE Contractor’s provider network. Additionally, the Contractor shall include a current provider directory and/or information on how to find a network provider near the member’ s residence on-line and via the Member Helpline. In accordance with 42 CFR 438.10(h), the provider directory must include the following information: ▪ Primary care physicians, specialists and hospitals; ▪ Name, location and telephone number of providers; ▪ Identification of non-English language spoken by providers; ▪ Provider web sites, if applicable; ▪ If the provider has accommodations for people with physical disabilities; ▪ Pharmacies and behavioral health providers; ▪ Contact information for all brokers contracted with the MCE; and ▪ Identification of providers that are not accepting new patients A printed copy of the provider directory must also be available to members and FSSA upon request. The Contractor must include the aforementioned provider network information, by county, on its member website. The information must be updated, at minimum, every two (2) weeks. Network provider information must be available to print from a remote user location.
