Common use of On-line Provider Website Clause in Contracts

On-line Provider Website. The MCP must have a secure internet-based website for contracting providers through which providers can confirm a consumer’s enrollment and through which providers can submit and receive responses to prior authorization requests (an e-mail process is an acceptable substitute if the website includes the MCP’s e-mail address for such submissions). The MCP provider website must also include, at a minimum, the following information which must be accessible to providers and the general public without any log-in restrictions: (1) MCP contact information, including the MCP’s designated contact for provider issues; (2) a listing of the counties the MCP serves unless the MCP serves the entire state in which case the MCP may indicate it services the entire states; (3) the MCP’s provider manual including the MCP’s claims submission process, as well as a list of services requiring PA, recent newsletters and announcements; (4) the MCP’s policies and procedures for out-of- network providers to seek payment of claims for emergency, post-stabilization and any other services authorized by the MCP; (5) the MCP’s on-line provider directory as referenced in section 41.a. of this appendix; and (6) the MCP’s PDL, including an explanation of the list and identification of any preferred drugs that require PA, the MCP’s list of drugs that require PA, including an explanation of the list, identification of first line drugs for drugs that require PA for step therapy, how to initiate a PA, and the MCP’s policy for coverage of generic versus brand name drugs. ODM may require the MCP to include additional information on the provider website as needed. The MCP must provide prescribers with in-office access to their preferred drug and PA lists via the availability of at least one hand-held software application. Provide all Healthchek information as specified in 25.b.i. of this Appendix.

On-line Provider Website. The MCP must have a secure internet-based website for contracting providers through which providers can confirm a consumer’s enrollment and through which providers can submit and receive responses to prior authorization requests (an e-mail process is an acceptable substitute if the website includes the MCP’s e-mail address for such submissions). The MCP provider website must also include, at a minimum, the following information which must be accessible to providers and the general public without any log-in restrictions: (1) MCP contact information, including the MCP’s designated contact for provider issues; (2) a listing of the counties the MCP serves unless the MCP serves the entire state in which case the MCP may indicate it services the entire statesstate; (3) the MCP’s provider manual including the MCP’s claims submission process, as well as a list of services requiring PA, recent newsletters and announcements; (4) the MCP’s policies and procedures for out-of- of-network providers to seek payment of claims for emergency, post-stabilization and any other services authorized by the MCP; (5) the MCP’s on-line provider directory as referenced in section 41.a. of this appendix; and (6) the MCP’s PDL, including an explanation of the list and identification of any preferred drugs that require PA, the MCP’s list of drugs that require PA, including an explanation of the list, identification of first line drugs for drugs that require PA for step therapy, how to initiate a PA, and the MCP’s policy for coverage of generic versus brand name drugs. The MCP must publish a thirty (30) days advance notice of changes to the MCP list of drugs requiring prior authorization via their website. ODM may require the MCP to include additional information on the provider website as needed. The MCP must provide prescribers with in-office access to their preferred drug and PA lists via the availability of at least one hand-held software application. Provide all Healthchek information as specified in 25.b.i. of this Appendix.

On-line Provider Website. The MCP MCOP must have a secure internet-based website for contracting providers through which providers can confirm a consumermember’s enrollment and through which providers can submit and receive responses to prior authorization requests (an e-mail process is an acceptable substitute if the website includes the MCPMCOP’s e-mail address for such submissions). The MCP provider website must contain accurate enrollment information for all members including whether a member is a dual benefits member or a Medicaid-only member, specifically using those terms. The MCOP provider website must also include, at a minimum, the following information which must be accessible to providers and the general public without any log-in restrictions: (1) MCP MCOP contact information, including the MCPMCOP’s designated contact for provider issues; (2) a listing of the counties the MCP MCOP serves unless the MCP MCOP serves the entire state in which case the MCP MCOP may indicate it services the entire states; (3) the MCPMCOP’s provider manual including the MCPMCOP’s claims submission process, as well as a list of services requiring PA, recent newsletters and announcements; (4) the MCPMCOP’s policies and procedures for out-of- of-network providers to seek payment of claims for emergency, post-stabilization and any other services authorized by the MCPMCOP; (5) the MCPMCOP’s on-line provider directory as referenced in section 41.a49.a. of this appendix; and (6) the MCPMCOP’s PDL, including an explanation of the list and identification of any preferred drugs that require PA, the MCPMCOP’s list of drugs that require PA, including an explanation of the list, identification of first line drugs for drugs that require PA for step therapy, how to initiate a PA, and the MCPMCOP’s policy for coverage of generic versus brand name drugs. ODM may require the MCP MCOP to include additional information on the provider website as needed. The MCP MCOP must provide prescribers with in-office access to their preferred drug and PA lists via the availability of at least one hand-held software application. Provide The MCOP must provide all Healthchek information as specified in 25.b.i26.c.i. of this Appendix.

On-line Provider Website. The MCP must have a secure internet-based website for contracting providers through which providers can confirm a consumer’s enrollment and through which providers can submit and receive responses to prior authorization requests (an e-mail process is an acceptable substitute if the website includes the MCP’s e-mail address for such submissions). The MCP provider website must also include, at a minimum, the following information which must be accessible to providers and the general public without any log-in restrictions: (1) MCP contact information, including the MCP’s designated contact for provider issues; (2) a listing of the counties the MCP serves unless the MCP serves the entire state in which case the MCP may indicate it services the entire states; (3) the MCP’s provider manual including the MCP’s claims submission process, as well as a list of services requiring PA, recent newsletters and announcements; (4) the MCP’s policies and procedures for out-of- network providers to seek payment of claims for emergency, post-stabilization and any other services authorized by the MCP; (5) the MCP’s on-line provider directory as referenced in section 41.a. of this appendix; and (6) the MCP’s PDL, including an explanation of the list and identification of any preferred drugs that require PA, the MCP’s list of drugs that require PA, including an explanation of the list, identification of first line drugs for drugs that require PA for step therapy, how to initiate a PA, and the MCP’s policy for coverage of generic versus brand name drugs. The MCP must publish a thirty (30) days advance notice of changes to the MCP list of drugs requiring prior authorization via their website. ODM may require the MCP to include additional information on the provider website as needed. The MCP must provide prescribers with in-office access to their preferred drug and PA lists via the availability of at least one hand-held software application. Provide all Healthchek information as specified in 25.b.i. of this Appendix.