DHS HCBS Waiver Provider Education. The Contractor shall distribute Provider packets, which the State or its designee will provide, to Enrollees and educate each Enrollee regarding the Enrollee’s responsibility to provide the Provider packets to Personal Assistants and all other individual Providers who provide Covered Services under the Persons with Disabilities HCBS Waiver, Persons with HIV/AIDS HCBS Waiver, or Persons with Brain Injury HCBS Waiver. The Contractor shall further educate Enrollees that such Providers may not begin providing Covered Services until the fully and correctly completed packets have been returned to and accepted by the local DHS-DRS office.
DHS HCBS Waiver Provider Education. Contractor shall distribute Provider packets, which the State or its designee will provide, to Enrollees and educate each Enrollee regarding the Enrollee’s responsibility to ensure Personal Assistants and all other Individual Providers who provide Covered Services under the Persons with disabilities HCBS Waiver, Persons with HIV/AIDS HCBS Waiver, or Persons with brain injury HCBS Waiver receive the Provider packets. Contractor shall further educate Enrollees that such Providers may not begin providing Covered Services until the fully and correctly completed packets have been returned to, and accepted by, the local DHS-DRS office. Provider communication. Contractor must maintain a regular means of communicating and providing information on changes in policies and procedures to Providers. The Department shall require that Contractor provide no less than thirty (30) days’ notice to Providers of proposed policy changes prior to implementation by Contractor. Contractor must notify Providers of any changes to prior authorization policies no less than thirty (30) days before the date of implementation. Contractor shall ensure that Contractor staff, employees, agents, subcontractors, and others acting on its behalf have received all required training and education to effectively service Network Providers. The Department may establish a process for Network Providers to evaluate the performance of Contractor staff. Provider services. Contractor shall maintain sufficient and adequately trained Provider service staff to enable Network and non-Network Providers to receive prompt resolution of their problems or inquiries. Coordination tools Contractor shall have in place the following technology to assist with Care Coordination and Provider/Enrollee communication: Enrollee profile. Contractor shall use technology and processes that effectively integrate data from a variety of sources to profile, measure, and monitor Enrollee profiles. Profiles will include demographics, eligibility data, claims payment information, care opportunities, care gap alerts, and Enrollee preferences. Care Management system. Contractor’s Care Coordinators will use the Care Management system to review assessments, interventions, and management of Chronic Health Conditions to gather information to support IPoCs and identification of Enrollees’ needs. Contractor shall have fully operational portals, which provide Enrollees and Providers access to relevant information from the Care Management sys...
