Care Management and Quality Improvement Sample Clauses

Care Management and Quality Improvement. Contractor and Participant agree to cooperate with and participate in PUGET SOUND HEALTH PARTNERS quality improvement programs, Enrollee appeals and grievances, and care management programs. For utilization management programs, this includes, but is not limited to, notification of admissions, applicable referral procedures, and reporting of clinical encounter data. Contractor and Participant further agrees to cooperate with PUGET SOUND HEALTH PARTNERS concurrent review and discharge planning procedures, by providing medical records and other necessary information regarding Enrollees’ care in progress, length of stay and discharge status upon PUGET SOUND HEALTH PARTNERS’ reasonable request. Contractor and Participant agree that such access and information provision will take place at no additional charge. Contractor and Participant acknowledge that care management services and functions may be performed by PUGET SOUND HEALTH PARTNERS or an affiliate or an outside utilization management entity designated by PUGET SOUND HEALTH PARTNERS.
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