Coverage and Services. Each MCP’s case management data submissions will be assessed for completeness and accuracy. The MCP is responsible for submitting a case management file every month. Failure to do so jeopardizes the MCP’s ability to demonstrate compliance with case management requirements. For detailed descriptions of the case management measures below, see ODJFS Methods for the ABD and CFC Medicaid Managed Care Programs Data Quality Measures.
Coverage and Services. The MCO must post prominent, easily understood information on its website for members and providers regarding the optimization of pregnancy outcomes. The MCO must include information for providers, trusted messengers (i.e., community health workers), and members about the prevention of preterm birth through the use of progesterone treatment by linking to the Ohio Perinatal Quality Collaborative's information about progesterone best practices at xxxxx://xxx.xxxx.xxx/prematurity-prevention?adlt=strict and the Ohio Department of Health's progesterone-messaging toolkit located at xxxx://XxXxxxXxxXxxx.xxx. The MCO must include a link to the official ODM notification of pregnancy and risk assessment form (PRAF 2.0) located at xxxxx://xxxxxxxx.xxxx.xxx/Provider/PRAF with a statement encouraging network providers to complete and submit the form to assist pregnant women in maintaining Medicaid eligibility and connecting to needed services and supports (e.g., home visiting). The MCO must post on its website the MCO's criteria for medical necessity determinations for services requiring authorization. In accordance with 42 CFR 438.915(a), the MCO must provide a hard copy of the MCO's medical necessity criteria to providers and members upon request. The MCO must receive prior written approval from ODM before adding any information to its website that would require ODM's prior approval in hard copy form (e.g., member handbook information). The MCO must include additional information on its website as determined necessary by ODM.
Coverage and Services can be adversely affected by radio interference, atmospheric conditions, geographic factors, network congestion, planned and/or unplanned maintenance works, outages on other networks and providers' sites, the configuration or limitations of the Customer’s recipient, Mobile Device or other operational or technical difficulties which means that You may not receive some or all of the Services in certain areas or at certain times. Coverage and Services can also change with network expansion or reconfiguration. In all aforementioned cases, We will not be liable to pay compensation to the Customer for any loss or damage resulting directly or indirectly because or from the interruption or breakdown of the Services for whatever reason.
Coverage and Services. 1. Basic Benefit Package Pursuant to OAC rule 5160-26-03(A), with limited exclusions, limitations and clarifications (see OAC rule 5160-26-03(H) and section G.2 of this appendix), MCPs must ensure that members have access to medically-necessary services covered by the Ohio Medicaid fee-for-service (FFS) program, and any additional services as specified in OAC rule 5160-26-03 and this Agreement. For information on Medicaid-covered services, MCPs must refer to the Ohio Department of Medicaid (ODM) website. MCP represents and warrants that services provided by the MCP to Extension Members comport with the Mental Health Parity and Addiction Equity Act (MHPAEA) and shall provide written evidence of such as requested by ODM. The following includes but is not limited to a general list of services covered through the MCP benefit package: • Inpatient hospital services • Outpatient hospital services • Rural health clinics (RHCs) and federally qualified health centers (FQHCs) • Physician services whether furnished in the physician’s office, the covered person’s home, a hospital, or elsewhere • Laboratory and x-ray services • Screening, diagnosis, and treatment services to children under the age of twenty-one
Coverage and Services. (a) While we will do our best to provide quality services, because of the nature of telecommunications, it is impossible to guarantee a fault-free Service, as the quality and coverage of the Services depends partly on our network, and partly on other Telecommunications Service Providers to which our Services are connected.
Coverage and Services. Each MCP’s screening, assessment, and case management data submissions will be assessed for completeness and accuracy. The MCP is responsible for submitting a screening and assessment file (see Section 1 .b. of Appendix M, Performance Evaluation, for exceptions to this requirement) and a case management file every month. Failure to do so jeopardizes the MCP’s ability to demonstrate compliance with CSHCN requirements. For detailed descriptions of the screening, assessment, and case management measures below, see ODJFS Methods for Screening, Assessment, and Case Management Data Quality Measures. Appendix L
Coverage and Services i. Applies to Covered Items where Accidental Damage Coverage or Wear and Tear Coverage is applicable.
Coverage and Services can be adversely affected by radio interference, atmospheric conditions, geographic factors, network congestion, maintenance, outages on other networks and providers sites, the configuration or limitations of the Customer recipient's, Mobile Device or other operational or technical difficulties which means that you may not receive some or all of the Services in certain areas or at certain times. Coverage and Services can also change with network expansion or reconfiguration. We may, from time to time, disconnect the Service or Services for a short period to perform maintenance and repair work. In all aforementioned cases We will not be liable to pay compensation to the Customer for any loss or damage resulting directly or indirectly because or from the interruption or breakdown of the Services for whatever reason.
Coverage and Services. We will always aim to provide reliable and high quality services. However, we cannot guarantee that the services will always be available, fault-free, and secure or that they will operate free from viruses or other harmful programmes or disabling features. The quality of our services depends partly on your equipment, hardware or device, partly on the network and partly on the other providers and telecommunications networks to which the network is connected. These services are provided through Vodafone and are supplied subject to Vodafone “On Account” Terms & Conditions which are deemed to be incorporated in these terms. Where they are in any way inconsistent, with these terms, these terms shall prevail.
Coverage and Services. The due date for submission of the MCP’s Emergency Department Diversion (EDD) program has been deleted and that section was revised to state that MCPs must have approved EDD programs which, if changed, require ODJFS approval. This correction was erroneously omitted from the draft document you originally received. As a result of the June 2, 2004, conference call, we have accentuated the need for MCPs to refer to the provider e-manuals on the ODJFS website as the definitive information source for the Medicaid covered-services specifications. The BMHC will also arrange for an upcoming technical assistance session on how to access and utilize the electronic provider manuals.
