New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have a written orientation plan or program for new Participants that includes: • Educational and preventive care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment process, • Access to behavioral health services, transportation, home modifications, etc., • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation plan or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-assigned or "M" Participant assigned) until five (5) business days before the Enrollment Date, unless otherwise requested by the Department.
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Samples: 2023 Community Healthchoices Agreement, 2022 Community Healthchoices Agreement
New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have written policies and procedures for new Participants or a written orientation plan or program for new Participants that includes: • Educational and preventive preventative care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment role of the Service Coordinator, • The needs assessment process, • The role of the PCPT, • PCSPs and the service planning process, • Access to behavioral health services, transportation, home modifications, etc., • Participant Self-Directed models, • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, MCO • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • Service Coordination Unit and how to contact it directly, if necessary. • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating coordination Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation policies and procedures, plan or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-auto assigned or "M" Participant assigned) until five (5) business days before the effective date of the Participant’s Enrollment Date, unless otherwise requested by the Department.
Appears in 1 contract
Samples: Community Healthchoices Agreement
New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) 30 days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have a written orientation plan or program for new Participants that includes: • Educational and preventive care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment needs assessment process, • Access to behavioral health services, transportation, home modifications, etc., • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation plan or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-auto assigned or "M" Participant assigned) until five (5) business days before the Enrollment Date, unless otherwise requested by the Department.
Appears in 1 contract
New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) 30 days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have a written orientation plan or program for new Participants that includes: • Educational and preventive care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment process, • Access to behavioral health services, transportation, home modifications, etc., • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation plan or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-assigned or "M" Participant assigned) until five (5) business days before the Enrollment Date, unless otherwise requested by the Department.
Appears in 1 contract
Samples: Community Healthchoices Agreement
New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) 30 days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have a written orientation plan or program for new Participants that includes: • Educational and preventive care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment process, • Access to behavioral health services, transportation, home modifications, etc., • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation plan or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-assigned or "M" Participant assigned) until five (5) business days before the Enrollment Date, unless otherwise requested by the Department.
Appears in 1 contract
Samples: Community Healthchoices Agreement
New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have written policies and procedures for new Participants or a written orientation plan or program for new Participants that includes: • Educational and preventive preventative care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment role of the Service Coordinator, • The needs assessment process, • The role of the PCPT, • PCSPs and the service planning process, • Access to behavioral health services, transportation, home modifications, etc., • Participant Self-Directed models, • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitationmedicalsituation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, MCO • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • Service Coordination Unit and how to contact it directly, if necessary. • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating coordination Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation policies and procedures, plan or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-auto assigned or "M" Participant assigned) until five (5) business days before the effective date of the Participant’s Enrollment Date, unless otherwise requested by the Department.
Appears in 1 contract
Samples: Community Healthchoices Agreement
New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have written policies and procedures for new Participants or a written orientation plan or program for new Participants that includes: • Educational and preventive care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment role of the Service Coordinator, • The needs assessment process, • The role of the PCPT, • PCSPs and the service planning process, • Access to behavioral health services, transportation, home modifications, etc., • Participant Self-Directed models, • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitationmedicalsituation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • The role of Service Coordination Unit and how to contact it directly, if necessary, • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation plan policies and procedures, plan, or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-auto assigned or "M" Participant assigned) until five (5) business days before the Enrollment Date, unless otherwise requested by the Department.
Appears in 1 contract
Samples: Community Healthchoices Agreement
New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have a written orientation plan or program for new Participants that includes: • Educational and preventive care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment process, • Access to behavioral health services, transportation, home modifications, etc., • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • Individual back-up plan, • Emergency Preparedness, • Employment Services, • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation plan or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-assigned or "M" Participant assigned) until five (5) business days before the Enrollment Date, unless otherwise requested by the Department.
Appears in 1 contract
Samples: Community Healthchoices Agreement
New Participant Orientation. The CHC-MCO must provide an orientation to a new Participant within thirty (30) 30 days of the new Participant’s start date with the CHC-MCO. For new Participant’s receiving LTSS, the CHC-MCO must conduct the orientation face-to-face (the orientation may be part of the service coordination visit). For purposes of New Participant Orientation, a Participant would be considered new to the CHC-MCO if they were not enrolled with the CHC-MCO 365 days prior to the current enrollment. The CHC-MCO must have a written orientation plan or program for new Participants that includes: • Educational and preventive care programs that include an emphasis on health promotion, wellness and healthy lifestyles and practices, • The proper use of the CHC-MCO identification card and the ACCESS Card, • The role of the PCP, • The Assessment needs assessment process, • Access to behavioral health services, transportation, home modifications, etc., • What to do in an emergency or urgent medical situation, • How to report abuse, neglect, and exploitation, • How to utilize services in other circumstances, • How to request information from the CHC-MCO, • How to register a Complaint, file a Grievance or request a DHS Fair Hearing, • Notice that balance billing is prohibited and what to do in the event a Provider balance bills, • What Expanded Services or Value-Added Services the CHC-MCO has been approved to provide and how long these are required to be available to Participants who qualify to receive them, • Assistance in coordinating Medicare services that are available to the Participant, • The benefit of enrolling in a Medicare Part D plan with a zero copay. For participant’s receiving LTSS, the orientation must also include the following topics: • The role of the Service Coordinator, • The role of the PCPT, • PCSPs and the service planning process, • Participant Self-Directed models (for Participants receiving HCBS), • The role of Service Coordination Unit and how to contact it directly, if necessary. The CHC-MCO must obtain the Department’s advance written approval of the orientation plan or program. The CHC-MCO is prohibited from contacting a Potential Participant who is identified on the Daily Participant Enrollment File with an automatic assignment indicator (either an "A" auto-auto assigned or "M" Participant assigned) until five (5) business days before the Enrollment Date, unless otherwise requested by the Department.
Appears in 1 contract