Adherence to BCBSM Quality and Utilization Management Policies. Adhere to all quality management, utilization management and reimbursement policies and procedures of BCBSM regarding precertification, case management, disease management, retrospective profiling, credentialing or privileging specific to particular procedures, billing limitations or other programs which may be in effect at the time the Covered Service is provided, and submit reports, including data, as requested by BCBSM;
Appears in 7 contracts
Samples: Ambulatory Surgery Facility Participation Agreement, Outpatient Physical Therapy Facility Traditional Participation Agreement, Outpatient Psychiatric Care Facility Participation Agreement
Adherence to BCBSM Quality and Utilization Management Policies. Adhere to all quality management, utilization management and reimbursement policies and procedures of BCBSM regarding precertification, case management, disease management, retrospective profiling, radiology management program, credentialing or privileging specific to particular procedures, billing limitations or other programs which may be in effect at the time the Covered Service is provided, and submit reports, including data, as requested by BCBSM;
Appears in 6 contracts
Samples: Participation Agreement, Participation Agreement, Participation Agreement
Adherence to BCBSM Quality and Utilization Management Policies. Adhere to all quality management, utilization management and reimbursement policies and procedures of BCBSM regarding precertification, case management, disease management, retrospective profiling, credentialing or privileging specific to particular procedures, billing limitations or other programs which may be in effect at the time the Covered Service is provided, and submit reports, including data, as requested by BCBSM;.
Appears in 2 contracts
Samples: Durable Medical Equipment/ Prosthetic and Orthotic Supplier Provider Participation Agreement, Durable Medical Equipment/ Prosthetic and Orthotic Supplier Provider Participation Agreement
Adherence to BCBSM Quality and Utilization Management Policies. Adhere to all quality management, utilization management and reimbursement policies and procedures of BCBSM regarding precertification, case management, disease management, retrospective profiling, credentialing or privileging specific to particular procedures, billing limitations limitations, or other programs which may be in effect at the time the Covered Service is provided, and submit reports, including data, as requested by BCBSM;
Appears in 2 contracts
Adherence to BCBSM Quality and Utilization Management Policies. Adhere to all quality management, utilization management and reimbursement policies and procedures of BCBSM regarding precertification, case management, disease management, retrospective profiling, credentialing or privileging specific to particular procedures, billing limitations or other programs which may be in effect at the time the Covered Service is provided, provided and submit reports, including lab value data, as requested by BCBSM;.
Appears in 1 contract
Adherence to BCBSM Quality and Utilization Management Policies. Adhere to all quality management, utilization management and reimbursement policies and procedures of BCBSM regarding precertification, case management, utilization or performance management, disease management, retrospective profiling, credentialing or privileging specific to particular procedures, billing limitations or other programs which may be in effect at the time the Covered Service is provided, and submit reports, including data, as requested by BCBSM. BCBSM agrees to furnish Provider with written information necessary to adhere to such policies, procedures and reporting requirements;
Appears in 1 contract
Samples: Outpatient Physical Therapy Facility Affiliation Agreement
Adherence to BCBSM Quality and Utilization Management Policies. Adhere to and cooperate with all quality management, utilization management and reimbursement policies and procedures of BCBSM regarding precertification, case management, disease management, retrospective profiling, radiology management program, credentialing or privileging specific to particular procedures, billing limitations or other programs which may be in effect at the time the Covered Service is provided, and submit reports, including data, as requested by BCBSM;
Appears in 1 contract
Samples: Participation Agreement
Adherence to BCBSM Quality and Utilization Management Policies. Adhere to all quality management, utilization management and reimbursement policies and procedures of BCBSM regarding precertification, case management, disease management, retrospective profiling, radiology management program, credentialing or privileging specific to particular procedures, billing limitations or other programs which may be in effect at the time the Covered Service is provided, and submit reports, including data, as requested by BCBSM;.
Appears in 1 contract
