Period of Enrollment. (A) An Enrollee shall be considered enrolled in the Contractor’s PMHP during the months in which the Contractor receives a Capitation Payment from the Department. (B) Until the Department notifies the Contractor that an Enrollee is no longer Medicaid eligible, the Contractor may assume that the Enrollee continues to be eligible. The Contractor is responsible for verifying enrollment using the most current information available from the Department. (C) The Contractor shall be responsible for payment of all Clean Claims for Covered Services rendered to an Enrollee for whom the Contractor has received a Capitation Payment. The Contractor is responsible for payment even where an Enrollee changes their county of residence during the month that the Contractor received a Capitation Payment.
Appears in 11 contracts
Samples: Prepaid Mental Health Plan, Prepaid Mental Health Plan Contract, Prepaid Mental Health Plan Contract
Period of Enrollment. (A) An Enrollee shall be considered enrolled in with the Contractor’s PMHP Contractor during the months in which the Contractor receives a Capitation Payment from the Department.
(B) Until the Department notifies the Contractor that an Enrollee is no longer Medicaid eligibleenrolled with the Contractor, the Contractor may shall assume that the Enrollee continues to be eligibleenrolled. The Contractor is responsible for verifying enrollment using the most current information available from the Department.
(C) The Contractor shall be responsible for payment of all Clean Claims for Covered Services rendered to an Enrollee for whom the Contractor has received a Capitation Payment. The Contractor is responsible for payment even where an Enrollee changes their county of residence during the month that the Contractor received a Capitation Payment.
Appears in 10 contracts
Samples: Utah Medicaid Contract, Utah Medicaid Contract, Utah Medicaid Contract
Period of Enrollment. (A) An Enrollee shall be considered enrolled in the Contractor’s PMHP during the months in which the Contractor receives a Capitation Payment from the Department.
(B) Until the Department notifies the Contractor that an Enrollee is no longer Medicaid eligibleenrolled with the Contractor, the Contractor may shall assume that the Enrollee continues to be eligibleenrolled. The Contractor is responsible for verifying enrollment using the most current information available from the Department.
(C) The Contractor shall be responsible for payment of all Clean Claims for Covered Services rendered to an Enrollee for whom the Contractor has received a Capitation Payment. The Contractor is responsible for payment even where an Enrollee changes their county of residence during the month that the Contractor received a Capitation Payment.
Appears in 7 contracts
Samples: Prepaid Mental Health Plan (Pmhp) Contract, Prepaid Mental Health Plan (Pmhp) Contract, Prepaid Mental Health Plan (Pmhp) Contract