Direct Member Reimbursement. Pursuant to OAC rule 5160-1-60.2, the MCO must comply with requirements for direct reimbursement for out-of-pocket expenses incurred by members for covered services during approved eligibility periods. If a member properly submits an ODM-approved direct reimbursement packet, the MCO must accept the ODM-approved direct reimbursement packet and complete the direct reimbursement process. If a member makes first contact with the MCO regarding direct reimbursement, the MCO must complete the direct reimbursement process but may use the MCO's own direct reimbursement process and documents.
Appears in 5 contracts
Samples: Baseline Provider Agreement, Baseline Provider Agreement, Baseline Provider Agreement
