Common use of New Participant Orientation Clause in Contracts

New Participant Orientation. The CHC-MCO must have written policies and procedures for new Participants or a written orientation plan or program that includes:  Educational and 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 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 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,  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 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 coordination Medicare services that are available to the Participant,  The benefit of enrolling in a Medicare Part D plan with a zero copay. The CHC-MCO must obtain the Department’s advance written approval of the 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 assigned or "M" Participant assigned) until five (5) business days before the effective date of the Participant’s Enrollment unless otherwise requested by the Department.

Appears in 1 contract

Samples: Community Healthchoices Agreement

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New Participant Orientation. The CHC-MCO must have written policies and procedures for new Participants or a written orientation plan or program that includes:  Educational and preventative 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 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 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,  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 coordination coordinating Medicare services that are available to the Participant,  The benefit of enrolling in a Medicare Part D plan with a zero copay. The CHC-MCO must obtain the Department’s advance written approval of the policies and procedures, plan 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 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 have written policies and procedures for new Participants or a written orientation plan or program that includes:  Educational and preventative 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 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 situationmedicalsituation,  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,  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 coordination coordinating Medicare services that are available to the Participant,  The benefit of enrolling in a Medicare Part D plan with a zero copay. The CHC-MCO must obtain the Department’s advance written approval of the policies and procedures, plan 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 effective date of the Participant’s Enrollment Date, unless otherwise requested by the Department.

Appears in 1 contract

Samples: Community Healthchoices Agreement

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New Participant Orientation. The CHC-MCO must have written policies and procedures for new Participants or a written orientation plan or program that includes:  Educational and 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 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 situationmedicalsituation,  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,  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 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 coordination Medicare services that are available to the Participant,  The benefit of enrolling in a Medicare Part D plan with a zero copay. The CHC-MCO must obtain the Department’s advance written approval of the 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 assigned or "M" Participant assigned) until five (5) business days before the effective date of the Participant’s Enrollment unless otherwise requested by the Department.

Appears in 1 contract

Samples: Community Healthchoices Agreement

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