Primary Care Network List Specifications Sample Clauses

Primary Care Network List Specifications. The MCO will provide a Primary Care Network List (PCNL) or a Provider directory that provides information about the MCO’s Medicare and Medicaid Provider network and that includes a description of the essential components of the MCO, to be used to educate consumers. This document must follow the STATE specifications as indicated in the STATE document “PCNL Guidelines,” and must also include information on how to access Home Care, transportation, and DME supplies.The PCNL must be prior approved by the STATE in accordance with section 3.10. The document must be printed on a grade of paper that is equivalent to bond paper that is not less than nineteen (19) pound bond but not greater than twenty (20) pound bond. If the PCNL has a cover, the grade of paper may be on un-coated offset paper or on glossy paper. The paper must be 8 ½" x 11" or 17" x 11". A 17" x 11" document must fold to 8 ½" x 11". The document must contain the following information: (1) A list of Participating Providers with addresses and phone numbers including clinics, Primary Care physicians, specialists, hospitals, nursing homes, and Care Systems Providers. The document must indicate Providers who speak a non-English language and identify Providers that are not accepting new patients within the Service Area at the time the list is prepared. The MCO may list other affiliated Providers and their addresses or provide a phone number where a Potential Enrollee may call to obtain the information. The information required by this section may also be listed on the MCO’s web site. (2) A toll-free telephone number that the Recipient may contact regarding MCO coverage or procedures, and updated information regarding Providers, spoken languages, and open and closed panels of Providers. (3) How to access oral interpretation for any language, and written information about how to obtain accessible accommodation information required under section 6.49, that will be available in prevalent non-English languages. (4) Information about how to access mental health, chemical dependency, Home Care, dental, and Medical Emergency and Urgent Care services. (5) A description of the MCO’s Care Systems, Case Management systems and any other distinguishing information that will assist the Enrollee in making a decision to enroll in the MCO’s SNBC product. (6) Information concerning the selection process, including a statement that the Enrollee must select an MCO in which their Primary Care Provider or specialist participat...

Primary Care Network List Specifications. The HEALTH PLAN must supply all Local Agencies within its Service Area, and the STATE for MinnesotaCare, with copies of a standardized document (known as a “ Primary Care Network List, or PCNL”) that provides information about the HEALTH PLAN’s provider network and that includes a description of the essential components of the HEALTH PLAN, to be used by the Local Agencies to educate consumers. This document must be prior approved by the STATE in accordance with Section