Common use of Base of Operations Clause in Contracts

Base of Operations. The Contractor shall have an Administrative Office within fifteen (15) miles of the Division of Medicaid’s High Street location in Jackson, Mississippi. The office must also have space for Division staff to work. The Mississippi Chief Executive Officer or person with comparable qualifications must be authorized and empowered to make operational and financial decisions, including rate negotiations for Mississippi business, claims payment, and provider relations/contracting. The CEO or comparable person must be able to make decisions about coordinated care activities and shall represent the Contractor at meetings required by the Division. The Mississippi-based location must include a designee who can respond to issues involving systems and reporting, appeals, quality assessment, member services, EPSDT services management, pharmacy management, medical management, and case management. CCOs must maintain a health information system that collects, analyzes, integrates, and reports data. The system must provide information on areas including, but not limited to, utilization, grievances and appeals, and disenrollments for other than loss of Medicaid eligibility. The health information system must collect data on enrollee and provider characteristics as specified by the State and on services furnished to enrollees through an encounter data system or other methods as may be specified by the State. CCOs will be required to operate both member and provider call centers. The member call center must be available to members 24 hours a day, seven days a week. The provider call center must operate during normal providers’ business hours. CCOs will be responsible for processing claims. The Division will establish minimum standards for financial and administrative accuracy and for timeliness of processing; these standards will be no less than the standards currently in place for the Medicaid fee- for-service program. CCOs will be required to submit complete encounter data to the Division that meets federal requirements and allows the Division to monitor the program. CCOs that do not meet standards will be penalized.

Base of Operations. The Contractor shall have an Administrative Office within fifteen (15) 15 miles of the Division of Medicaid’s High Street location in Jackson, Mississippi. The office must also have space for Division staff to work. The Mississippi Chief Executive Officer or person with comparable qualifications must be authorized and empowered to make operational and financial decisions, including rate negotiations for Mississippi business, claims payment, and provider relations/contracting. The CEO or comparable person must be able to make decisions about coordinated care activities and shall represent the Contractor at meetings required by the Division. The Mississippi-Mississippi- based location must include a designee who can respond to issues involving systems and reporting, appeals, quality assessment, member services, EPSDT services management, pharmacy management, medical management, and case management. CCOs must maintain a health information system that collects, analyzes, analyzes integrates, and reports data. The system must provide information on areas including, but not limited to, utilization, grievances and appeals, and disenrollments for other than loss of Medicaid eligibility. The health information system must collect data on enrollee and provider characteristics as specified by the State and on services furnished to enrollees through an encounter data system or other methods as may be specified by the State. CCOs will be required to operate both member and provider call centers. The member call center must be available to members 24 hours a day, seven days a week. The provider call center must operate during normal providers’ business hours. CCOs will be responsible for processing claims. The Division will establish minimum standards for financial and administrative accuracy and for timeliness of processing; these standards will be no less than the standards currently in place for the Medicaid fee- for-service program. CCOs will be required to submit complete encounter data to the Division that meets federal requirements and allows the Division to monitor the program. CCOs that do not meet standards will be penalized.

Base of Operations. The Contractor shall have an Administrative Office within fifteen (15) miles of the Division of Medicaid’s High Street location in Jackson, Mississippi. The office must also have space for Division staff to work. The Mississippi Chief Executive Officer or person with comparable qualifications must be authorized and empowered to make operational and financial decisions, including rate negotiations for Mississippi business, claims payment, and provider relations/contracting. The CEO or comparable person must be able to make decisions about coordinated care activities and shall represent the Contractor at meetings required by the Division. The Mississippi-based location must include a designee who can respond to issues involving systems and reporting, appeals, quality assessment, member services, EPSDT services management, pharmacy management, medical management, and case management. CCOs Contractor must maintain a health information system that collects, analyzes, integrates, and reports data. The system must provide information on areas including, but not limited to, utilization, grievances and appeals, and disenrollments dis-enrollments for other than loss of Medicaid eligibility. The health information system must collect data on enrollee and provider characteristics as specified by the State and on services furnished to enrollees through an encounter data system or other methods as may be specified by the State. CCOs Contractor will be required to operate both member and provider call centers. The member call center must be available to members 24 hours a day, seven days a week. The provider call center must operate during normal providers’ business hours. CCOs Contractor will be responsible for processing claims. The Division will establish minimum standards for financial and administrative accuracy and for timeliness of processing; these standards will be no less than the standards currently in place for the Medicaid fee- for-service program. CCOs Contractor will be required to submit complete encounter data to the Division that meets federal requirements and allows the Division to monitor the program. CCOs A Contractor that do does not meet standards will be penalized.