Common use of CONTRACTOR Responsibility for PCP Services Clause in Contracts

CONTRACTOR Responsibility for PCP Services. The CONTRACTOR shall retain responsibility for monitoring PCP activities to ensure compliance with the CONTRACTOR’s and HSD’s policies. The CONTRACTOR shall establish mechanisms to ensure that Network Providers comply with the timely access requirements, monitor regularly to determine compliance and take corrective action if there is a failure to comply. The CONTRACTOR shall educate PCPs about special populations and their service needs. The CONTRACTOR shall ensure that PCPs successfully identify and refer Members to Specialty Providers as Medically Necessary.

CONTRACTOR Responsibility for PCP Services. A. The CONTRACTOR shall retain responsibility for monitoring PCP activities to ensure compliance with the CONTRACTOR’s CONTRACTOR and HSD’s HSD policies. The CONTRACTOR shall establish mechanisms to ensure that Network Providers comply with the timely access requirements, monitor regularly to determine compliance and take corrective action if there is a failure to comply. The CONTRACTOR shall educate PCPs about special populations and their service needs. The CONTRACTOR shall ensure that PCPs successfully identify and refer Members patients to Specialty Providers specialty providers as Medically Necessarymedically necessary. B. The CONRACTOR shall have an internal provider appeals process.

CONTRACTOR Responsibility for PCP Services. The CONTRACTOR shall retain responsibility for monitoring PCP activities to ensure compliance with the CONTRACTOR’s and HSDthe State’s policies. The CONTRACTOR shall establish mechanisms to ensure that Network Providers comply with the timely access requirements, monitor regularly to determine compliance and take corrective action if there is a failure to comply. The CONTRACTOR shall educate PCPs about special populations and their service needs. The CONTRACTOR shall ensure that PCPs successfully identify and refer Members to Specialty Providers as Medically Necessary.

CONTRACTOR Responsibility for PCP Services. A. The CONTRACTOR shall retain responsibility for monitoring PCP activities to ensure compliance with the CONTRACTOR’s CONTRACTOR and HSD’s /MAD policies. The CONTRACTOR shall establish mechanisms to ensure that Network Providers comply with the timely access requirements, monitor regularly to determine compliance and take corrective action if there is a failure to comply. The CONTRACTOR shall educate PCPs about special populations and their service needs. The CONTRACTOR shall ensure that PCPs successfully identify and refer Members patients to Specialty Providers specialty providers as Medically Necessarymedically necessary. B. The CONTRACTOR shall have an internal provider appeals process.