Member Handbook and New Member Letter. The MCOP shall use the model language specified by ODM and/or CMS for the new member letter and member handbooks. 1. The MCOP shall mail the new member letter, waiver handbook, if applicable, and member handbook postcard that provides how a member can obtain a printed or electronic version of the member handbook, separate from the ID card. The MCOP will meet the timeliness requirement for mailing these materials if they are mailed to members within five business days of the MCOP receiving the ODM produced HIPAA 834C, that lists the individual as a new member. 2. The MCOP New Member Letter shall inform each member of the following: a. The new member materials issued by the MCOP, what action to take if he or she did not receive those materials, and how to access the MCOP’s provider directory; b. How to access MCOP-provided transportation services; c. How to change primary care providers; d. The population groups not required to select MCOP membership and what action to take if a member believes he or she meets these criteria and does not want to be an MCOP member; e. The need and time frame for a member to contact the MCOP if he or she has a health condition the MCOP should be aware of in order to most appropriately manage or transition the member’s care; and f. The need and how to access information on medications that require prior authorization. 3. The MCOP Member Handbook shall be clearly labeled as such and shall include: a. The rights of members including all rights found in OAC rule 5160-26-
Appears in 5 contracts
Samples: Provider Agreement, Provider Agreement, Provider Agreement
Member Handbook and New Member Letter. The MCOP shall use the model language specified by ODM and/or CMS for the new member letter and member handbooks.
1. The MCOP shall mail the new member letter, waiver handbook, if applicable, and member handbook postcard that provides how a member can obtain a printed or electronic version of the member handbook, separate from the ID card. The MCOP will meet the timeliness requirement for mailing these materials if they are mailed to members within five business days of the MCOP receiving the ODM produced HIPAA 834C, that lists the individual as a new member.
2. The MCOP New Member Letter shall inform each member of the following:
a. The new member materials issued by the MCOP, what action to take if he or she did not receive those materials, and how to access the MCOP’s provider directory;
b. How to access MCOP-provided transportation services;
c. How to change primary care providers;
d. The population groups not required to select MCOP membership and what action to take if a member believes he or she meets these this criteria and does not want to be an MCOP member;
e. The need and time frame for a member to contact the MCOP if he or she has a health condition the MCOP should be aware of in order to most appropriately manage or transition the member’s care; and
f. The need and how to access information on medications that require prior authorization.
3. The MCOP Member Handbook shall be clearly labeled as such and shall include:
a. The rights of members including all rights found in OAC rule 5160-26-
Appears in 4 contracts
Samples: Provider Agreement, Provider Agreement, Provider Agreement
