Common use of Enrollee Services Clause in Contracts

Enrollee Services. i. A description of all available Coordinated Care covered services, including EPSDT and other preventive services, and an explanation of any service limitations, referral and prior authorization requirements. The description shall include the procedures for obtaining benefits, including family planning services, from out-of-network providers. ii. A description of the enhanced services that the Contractor offers. iii. Instructions on how to contact Member or Customer Services of the Contractor and a description of the functions of Member or Customer Services. iv. Notification that each enrollee is entitled to a copy of his or her medical records and instructions on how to request those records from the Contractor. v. Instructions on how to utilize the after-hours Medical Advice and Customer Services Department of the Contractor. vi. A description of the Contractor’s confidentiality policies. vii. Instructions on how enrolled individuals may acquire services that are covered under Mississippi Medicaid but not under the MississippiCAN.