Online Provider Directory Sample Clauses

Online Provider Directory. The HMO must post a provider directory on their website for members, network providers, and the Department to access. The file must include the following information:

Online Provider Directory. The PIHP must post a provider directory specific to the FCMH program on their website for members, network providers, and the Department to access. The file must include, the following information:  Provider full name and phone number;  Clinic Address;  Specialty;  Languages spoken; and  If they are accepting new patients.

Online Provider Directory. The HMO must post a provider directory on their website for members, network providers, and the Department to access. The file must include the following information: • Provider full name and phone number; • Clinic Address; • Specialty; • Languages spoken; and • If they are accepting new patients. I. Responsibilities to Members 1. Advocate Requirements a. Functions of the BadgerCare Plus and/or Medicaid SSI HMO Advocate(s) 1) Investigate and resolve access and cultural sensitivity issues identified by HMO staff, State staff, providers, advocate organizations, and members. 2) Monitor formal and informal grievances with the grievance personnel for purposes of identification of trends or specific problem areas of access and care delivery. The monitoring function includes ongoing participation in the HMO grievance committee. 3) Recommend policy and procedural changes to HMO management including those needed to ensure and/or improve member access to and quality of care. The recommended changes can be for both internal administrative policies and subcontracted providers. 4) Act as the primary contact for member advocacy groups. Work with member advocacy groups on an ongoing basis to identify and correct member access barriers. 5) Act as the primary contact for local community based organizations (local governmental units, non-profit agencies, etc.). Work with the local community based organizations on an ongoing basis to acquire knowledge and insight regarding the special health care needs of members. 6) Participate in working with DHCAA Managed Care staff assigned to the HMO on issues of access to medical care, quality of medical care, and working with the enrollment specialist, ombudsmen, and the Department’s approved external advocate on issues of access to medical care, quality of medical care, and enrollment and disenrollment. 7) Analyze on an ongoing basis internal HMO system functions that affect member access to medical care and quality of medical care. 8) Organize and provide ongoing training and educational materials for the HMO staff and providers to enhance their understanding of the values and practices of all cultures with which the HMO interacts. 9) Provide ongoing input to the HMO management on how changes in the HMO provider network will affect member access to medical care and member quality and continuity of care. Participate in the development and coordination of plans to minimize any potential problems that could be caused by provider networ...