New Member Orientation. Contractor shall have written policies and procedures for orienting new members to their benefits, how to utilize services in other circumstances, how to register a complaint or file a grievance. These policies and procedures shall take into account the multi-lingual, multi-cultural nature of the population. All enrollment notices, informational materials and instructional materials relating to members should be written at no higher than a sixth-grade level, presented in a manner and format that may be easily understood. All written material must be available in alternative formats and in an appropriate manner that takes into consideration the special needs of those who are visually limited or have limited reading proficiency. All members must be informed that information is available in alternative formats and how to access those formats. Contractor shall make at least four (4) attempts, on different days, and at different times of the day, to make a welcome call to all new members within thirty (30) days of enrollment to provide the same information as described in the paragraph above. Welcome call scripts shall also solicit whether members have a regular dentist within the network, and whether they have new or existing dental care needs. In the event that a welcome call identifies any new members who have existing health care needs immediate steps will be taken to ensure the member’s needs are met. Any scripts developed or used by the Contractor for these purposes shall be subject to review and prior approval by EOHHS. Orientation Process for members shall include a contact to acquaint the member to the Contractor. Any script or other materials developed by the Contractor for this purpose is subject to review and prior approval by EOHHS.
Appears in 3 contracts
Samples: Medicaid Program Agreement, Medicaid Rite Smiles Program Agreement, Medicaid Rite Smiles Program Agreement
New Member Orientation. Contractor shall have written policies and procedures for orienting new members to their benefits, how to utilize services in other circumstances, how to register a complaint or file a grievance. These policies and procedures shall take into account the multi-multi- lingual, multi-cultural nature of the population. All enrollment notices, informational materials and instructional materials relating to members should be written at no higher than a sixth-grade level, presented in a manner and format that may be easily understood. All written material must be available in alternative formats and in an appropriate manner that takes into consideration the special needs of those who are visually limited or have limited reading proficiency. All members must be informed that information is available in alternative formats and how to access those formats. Contractor shall make at least four (4) attempts, on different days, and at different times of the day, to make a welcome call to all new members within thirty (30) days of enrollment to provide the same information as described in the paragraph above. Welcome call scripts shall also solicit whether members have a regular dentist within the network, and whether they have new or existing dental care needs. In the event that a welcome call identifies any new members who have existing health care needs immediate steps will be taken to ensure the member’s needs are met. Any scripts developed or used by the Contractor for these purposes shall be subject to review and prior approval by EOHHS. Orientation Process for members shall include a contact to acquaint the member to the Contractor. Any script or other materials developed by the Contractor for this purpose is subject to review and prior approval by EOHHS.
Appears in 2 contracts
Samples: Agreement for the Medicaid Rite Smiles Program, Medicaid Agreement
New Member Orientation. Contractor shall have written policies and procedures for orienting new members to their benefits, how to utilize services in other circumstances, how to register a complaint or file a grievance. These policies and procedures shall take into account the multi-lingual, multi-cultural nature of the population. All enrollment notices, informational materials and instructional materials relating to members should be written at no higher than a sixth-grade level, presented in a manner and format that may be easily understood. All written material must be available in alternative formats and in an appropriate manner that takes into consideration the special needs of those who are visually limited or have limited reading proficiency. All members must be informed that information is available in alternative formats and how to access those formats. Contractor shall make at least four (4) attempts, on different days, and at different times of the day, to make a welcome call to all new members within thirty (30) days of enrollment to provide the same information as described in the paragraph above. Welcome call scripts shall also solicit whether members have a regular dentist within the network, and whether they have new or existing dental care needs. In the event that a welcome call identifies any new members who have existing health care needs immediate steps will be taken to ensure the member’s needs are met. Any scripts developed or used by the Contractor for these purposes shall be subject to review and prior approval by EOHHS. Orientation Process for members shall include a contact to acquaint the member to the Contractor. Any script or other materials developed by the Contractor for this purpose is subject to review and prior approval by EOHHS.
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