Health Net Policies. The policies, procedures and programs established by Health Net and applicable to Provider in effect at the time Covered Services are rendered, including without limitation Health Net’s grievance and appeal procedures, provider dispute and/or appeal process, drug formulary or preferred drug list, fraud detection, recovery procedures, eligibility verification, billing and coding guidelines, payment and review policies, anti-discrimination requirements, medical management programs, continuity of care policies, provider manuals and/or operations manuals.
Health Net Policies. Provider shall participate in and comply with all Health Net Policies in effect on the effective date of this Agreement, and as modified periodically by Health Net in accordance with Section 3.2 of this Agreement. Provider hereby acknowledges that it has had the opportunity to review Health Net Policies regarding quality improvement and utilization management that pertain to Health Net and Provider’s rights and obligations under this Agreement at least fifteen (15) business days prior to the date Provider has executed this Agreement.
Health Net Policies. Health Net Policies are set forth in references and forms available to Provider through Health Net’s website or by other means which Health Net will communicate to Provider periodically. Health Net Policies in existence as of the effective date of this Agreement are hereby incorporated into this Agreement by reference. Notwithstanding the foregoing and/or any other provision of this Agreement, the parties agree that a formal amendment to this Agreement shall not be required to effectuate modifications to Health Net Policies. Modifications to Health Net Policies may be made periodically as determined by Health Net in accordance with the procedures set forth in applicable State law (including without limitation the California Health Care Providers’ Bill of Rights). Such modifications shall be deemed incorporated in this Agreement as of the effective date of such modification unless otherwise mutually agreed by the parties in writing at the time of the modification in accordance with applicable State law (including without limitation the California Health Care Providers’ Bill of Rights).
