Common use of Provider Directories Clause in Contracts

Provider Directories. The PH-MCO must make available directories for all types of Network Providers, including, but not limited to: PCPs, hospitals, specialists, Providers of ancillary services, Nursing Facilities, etc. The PH-MCO must utilize a web-based Provider directory. The PH-MCO must establish a process to ensure the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The PH-MCO must perform monthly reviews of the web-based Provider directory, subject to random monitoring by the Department to ensure complete and accurate entries. The PH-MCO must provide the EAP broker with an updated electronic version of its Provider directory at a minimum on a weekly basis. This will include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The PH-MCO must utilize the file layout and format specified by the Department. The format must include, but not be limited to the following:  Correct PROMISe™ Provider ID  All Providers in the PH-MCO’s Network  The location where the PCP will see Members, as well as whether the PCP has evening and/or weekend hours  Wheel chair accessibility of Provider sites  Language indicators including non-English language spoken by current Providers in the Member’s service area. A PH-MCO will not be certified as “ready” without the completion of the electronic Provider directory component as determined and provided by the Department on the HealthChoices Intranet site. The PH-MCO must notify its Members annually of their right to request and obtain Provider directories. Upon request, the PH- MCO must provide its Members with directories for PCPs, dentists, specialists, hospitals, and Providers of ancillary services, which include, at a minimum, the information listed in Exhibit FF of this Agreement, PCP, Dentists, Specialists and Providers of Ancillary Services Directories. Upon request from the Member, the PH-MCO may print the most recent electronic version from their Provider file and mail it to the Member. The PH-MCO must submit PCP, specialist, and Provider of ancillary services directories to the Department for advance written approval before distribution to its Members if there are significant format changes to the directory. The PH-MCO also must make modifications to its Provider directories if ordered by the Department.

Provider Directories. ‌ The PH-MCO must make available directories for all types of Network Providers, including, but not limited to: PCPs, hospitals, specialists, Providers of ancillary services, Nursing Facilities, etc. The PH-MCO must utilize a web-based Provider directory. The PH-MCO must establish a process to ensure the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The PH-MCO must perform monthly reviews of the web-based Provider directory, subject to random monitoring by the Department to ensure complete and accurate entries. The PH-MCO must provide the EAP broker with an updated electronic version of its their Provider directory at a minimum on a weekly basis. This will include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The PH-MCO must utilize the file layout and format specified by the Department. The format must include, but not be limited to the following:  Correct PROMISe™ Provider ID  All Providers in the PH-MCO’s Network  The location where the PCP will see Members, as well as whether the PCP has evening and/or weekend hours  Wheel chair accessibility of Provider sites  Language indicators including non-English language spoken by current Providers in the Member’s service area. A PH-MCO will not be certified as “ready” without the completion of the electronic Provider directory component as determined and provided by the Department on the HealthChoices Intranet site. The PH-MCO must notify its Members annually of their right to request and obtain Provider directories. Upon request, the PH- MCO must provide its Members with directories for PCPs, dentists, specialists, hospitals, and Providers of ancillary services, which include, at a minimum, the information listed in Exhibit FF of this Agreement, PCP, Dentists, Specialists and Providers of Ancillary Services Directories. Upon request from the Member, the PH-MCO may print the most recent electronic version from their Provider file and mail it to the Member. The PH-MCO must submit PCP, specialist, and Provider of ancillary services directories to the Department for advance written approval before distribution to its Members if there are significant format changes to the directory. The PH-MCO also must make modifications to its Provider directories if ordered by the Department.

Provider Directories. The PH-MCO must make available directories for all types of Network Providers, including, but not limited to: PCPs, hospitals, specialists, Providers of ancillary services, Nursing Facilities, etc. The PH-MCO must utilize a web-based Provider directory. The PH-MCO must establish a process to ensure the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The PH-MCO must perform monthly reviews of the web-based Provider directory, subject to random monitoring by the Department to ensure complete and accurate entries. The PH-MCO must provide the EAP broker with an updated electronic version of its Provider directory at a minimum on a weekly basis. This will include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The PH-MCO must utilize the file layout and format specified by the Department. The format must include, but not be limited to the following:  • Correct PROMISe™ Provider ID  • All Providers in the PH-MCO’s Network  • The location where the PCP will see Members, as well as whether the PCP has evening and/or weekend hours  • Wheel chair accessibility of Provider sites  • Language indicators including non-English language spoken by current Providers in the Member’s service area. A PH-MCO will not be certified as “ready” without the completion of the electronic Provider directory component as determined and provided by the Department on the HealthChoices Intranet site. The PH-MCO must notify its Members annually of their right to request and obtain Provider directories. Upon request, the PH- MCO must provide its Members with directories for PCPs, dentists, specialists, hospitals, and Providers of ancillary services, which include, at a minimum, the information listed in Exhibit FF of this Agreement, PCP, Dentists, Specialists and Providers of Ancillary Services Directories. Upon request from the Member, the PH-MCO may print the most recent electronic version from their Provider file and mail it to the Member. The PH-MCO must submit PCP, specialist, and Provider of ancillary services directories to the Department for advance written approval before distribution to its Members if there are significant format changes to the directory. The PH-MCO also must make modifications to its Provider directories if ordered by the Department.

Provider Directories. ‌ The PH-MCO must make available directories for all types of Network Providers, including, but not limited to: PCPs, hospitals, specialists, Providers of ancillary services, Nursing Facilities, etc. The PH-MCO must utilize a web-based Provider directory. The PH-MCO must establish a process to ensure the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The PH-MCO must perform monthly reviews of the web-based Provider directory, subject to random monitoring by the Department to ensure complete and accurate entries. The PH-MCO must provide the EAP broker with an updated electronic version of its their Provider directory at a minimum on a weekly basis. This will include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The PH-MCO must utilize the file layout and format specified by the Department. The format must include, but not be limited to the following:  • Correct PROMISe™ Provider ID  • All Providers in the PH-MCO’s Network  • The location where the PCP will see Members, as well as whether the PCP has evening and/or weekend hours  • Wheel chair accessibility of Provider sites  • Language indicators including non-English language spoken by current Providers in the Member’s service area. A PH-MCO will not be certified as “ready” without the completion of the electronic Provider directory component as determined and provided by the Department on the HealthChoices Intranet site. The PH-MCO must notify its Members annually of their right to request and obtain Provider directories. Upon request, the PH- MCO must provide its Members with directories for PCPs, dentists, specialists, hospitals, and Providers of ancillary services, which include, at a minimum, the information listed in Exhibit FF of this Agreement, PCP, Dentists, Specialists and Providers of Ancillary Services Directories. Upon request from the Member, the PH-MCO may print the most recent electronic version from their Provider file and mail it to the Member. The PH-MCO must submit PCP, specialist, and Provider of ancillary services directories to the Department for advance written approval before distribution to its Members if there are significant format changes to the directory. The PH-MCO also must make modifications to its Provider directories if ordered by the Department.