Provider Directory a. The Contractor shall make available in electronic form and, upon request, in paper form, the following information about its network providers:
i. The provider’s name as well as any group affiliation;
ii. Street address(es);
iii. Telephone number(s);
iv. Website URL, as appropriate;
v. Specialty, as appropriate;
vi. Whether the provider will accept new beneficiaries;
vii. The provider’s cultural and linguistic capabilities, including languages (including American Sign Language) offered by the provider or a skilled medical interpreter at the provider’s office, and whether the provider has completed cultural competence training; and
viii. Whether the provider’s office/facility has accommodations for people with physical disabilities, including offices, exam room(s) and equipment.
b. The Contractor shall include the following provider types covered under this Agreement in the provider directory:
i. Physicians, including specialists ii. Hospitals
Provider Directory. 50.4.1. CONTRACTOR must follow the COUNTY’S provider directory policy, in compliance with MHSUDS IN 18-020.
50.4.2. CONTRACTOR must make available to clients, in paper form upon request and electronic form, specified information about the County provider network as per 42 C.F.R. § 438.10(h). The most current provider directory is electronically available on the COUNTY website and is updated by the COUNTY no later than 30 calendar days after information is received to update provider information. A paper provider directory must be updated as set forth in 42 C.F.R. § 438.10(h)(3)(i).
50.4.3. Any changes to information published in the provider directory must be reported to the COUNTY within two weeks of the change.
50.4.4. CONTRACTOR will only need to report changes/updates to the provider directory for licensed, waivered, or registered mental health providers.
Provider Directory. The names and addresses of Entrust Plan Participating Providers and Hospitals are set forth in a separate booklet which, by reference, is made a part hereof. The list of Participating Providers, which may change from time to time, will be provided to all Contractholders. The list of Participating Providers may also be accessed from AvMed’s website at xxx.xxxxx.xxx. Health Professionals may from time to time cease their affiliation with AvMed. In such cases, Members may be required to receive services from another participating Health Professional. Notwithstanding the printed booklet, the names and addresses of Participating Providers on file with AvMed at any given time will constitute the official and controlling list of Participating Providers.
Provider Directory a. The Health Plan shall mail a Provider Directory to all new Enrollees, including Enrollees who reenrolled after the Open Enrollment period. The Health Plan shall provide the most recently printed Provider Directory and include an addendum listing those physicians, etc., no longer providing services to Enrollees of the Health Plan and those physicians, etc., that have entered into an agreement to provide services to Enrollees of the Health Plan since the Health Plan published the most recently printed Provider Directory. In lieu of the Provider Directory addendum, the Health Plan may enclose a letter, in Times New Roman font, and at the fourth-grade reading level (as is required of all documents mailed to Enrollees) stating that the most recent listing of Providers is available by calling the Health Plan at its toll-free telephone number and at the Health Plan's website and provide the Internet address that will take the Enrollee directly to the online Provider Directory, without having to go to the Health Plan's home page or any other website as a prerequisite to viewing the online Provider Directory. The Health Plan must obtain the Agency's prior written approval of the letter.
b. The Provider Directory shall include the names, locations, office hours, telephone numbers of, and non-English languages spoken by, current Health Plan Providers. The Provider Directory shall include, at a minimum, information relating to PCPs, specialists, pharmacies, hospitals, certified nurse midwives and licensed midwives, and Ancillary Providers. The Provider Directory shall also identify Providers that are not accepting new patients.
c. The Health Plan shall maintain an online Provider Directory. The Health Plan shall update the online Provider Directory on, at least, a monthly basis. The Health Plan shall file an attestation to this effect with the Bureau of Managed Health Care and the Bureau of Health Systems Development.
d. If the Health Plan elects to use a more restrictive pharmacy network than the network available to Medicaid Recipients enrolled in the Medicaid FFS program, then the Provider Directory must include the names of the participating pharmacies. If all pharmacies are part of a chain and are within the Health Plan's Service Area under contract with the Health Plan, the Provider Directory need only list the chain name.
e. In accordance with section 1932(b)(3) of the Social Security Act, the Provider Directory shall include a statement that some Providers ...
Provider Directory. The CHC-MCO must maintain a single directory for all types of Network Providers. The CHC-MCO must utilize a web-based Provider directory. The web-based Provider directory must be available in a machine-readable file and format as specified in 42 C.F.R. § 438.10. The web-based Provider directory must be updated no less than thirty (30) days after the CHC-MCO receives updated information from the Provider. The CHC-MCO must establish a process to address the accuracy of electronically posted content, including a method to monitor and update changes in Provider information. The CHC-MCO must perform at least monthly reviews and revisions of the web-based Provider directory, subject to random monitoring by the Department. The CHC-MCO must provide the IEB with an updated electronic version of its Provider directory on at least a weekly basis. The file must include information regarding terminations, additions, PCPs and specialists not accepting new assignments, and other information determined by the Department to be necessary. The CHC-MCO must utilize the file layout and format specified by the Department. The file must include the information specified in Exhibit N, Provider Directory, but not be limited to: • Correct MMIS Provider ID • All Providers in the CHC-MCO’s Network • Locations where the PCP will see Participants and if evening or weekend hours are available • Wheelchair accessibility of Provider sites • List of non-English language(s) spoken by Providers. The CHC-MCO must notify its Participants annually of their right to request and obtain a hard copy of the Provider directory and where the online directory may be found. Upon request, the CHC-MCO must provide Participants with a hard copy of its Provider directory in the prevalent languages specified by the Department and in alternative formats. The CHC- MCO must review the Provider directory information and make any necessary updates at least monthly. Upon request from a Participant, the CHC-MCO must print the most recent electronic version from its Provider file and mail it to the Participant. The CHC-MCO must submit the Provider directory to the Department for advance written approval before distribution to its Participants. Unless the CHC-MCO makes significant format or substantive changes, the CHC-MCO is not required to submit changes to the Department for approval. The CHC-MCO must reference and include a link to the Provider directory for the aligned D-SNP in the Provider directory so that Par...
Provider Directory. 17.1 The Contractor must make available to beneficiaries, in paper form upon request and electronic form, specified information about its provider network as per 42 C.F.R. § 438.10(h). The most current provider directory is electronically available on the BHRS website and is updated by the MHP no later than 30 calendar days after information is received to update provider information.
17.2 Any changes to the provider directory must be reported to the MHP within two weeks of the change. Provider directory change/update requests by the Contractor must be made by filling out the electronic “BHRS Provider Directory Change Request Form” located on the BHRS website under BHRS Medi-Cal Provider Directory section.
17.3 Contractors will only need to report changes/updates to the provider directory for licensed, waivered, or registered mental health providers.
17.4 The provider directory is provided and maintained by the MHP as per language and format requirements outlined in 42 C.F.R. § 438.10 (d).
Provider Directory. The Provider Directory for each MCO Program, and any substantive revisions, must be approved by HHSC prior to publication and distribution, with the exception of PCP information changes or clerical corrections. The MCO is responsible for submitting draft Provider Directory updates to HHSC for prior review and approval. As described in Section 7, “Transition Phase Requirements,” during Readiness Review the MCO must develop and submit to HHSC the draft Provider Directory template for approval and must submit a final Provider Directory incorporating changes required by HHSC prior to the Operational Start Date. Such draft and final Provider Directories must be submitted according to the deadlines established in Section 7, “Transition Phase Requirements.”
Provider Directory. Contractor shall make its Provider Directory available to Providers via Contractor’s web-portal and as described in Section 2.17.
Provider Directory. The Contractor shall develop, regularly maintain and make available Provider Directories that include information for all types of Providers in the Contractor’s network, including, but not limited to PCPs, hospitals, specialists, Providers of ancillary services, behavioral health/ substance use disorder facilities, and pharmacies. In accordance with 42 C.F.R. § 438.10(h), the Provider Directory shall include, but is not limited to, the following information for physicians (including, but limited to, specialists), hospitals, pharmacies, and behavioral health providers:
1. Provider’s name as well as any group affiliation;
2. Street address(es);
3. Telephone number(s);
Provider Directory. The Provider Directory for each applicable HMO Program, and any substantive revisions, must be approved by HHSC prior to publication and distribution. The HMO is responsible for submitting draft Provider directory updates to HHSC for prior review and approval if changes other than PCP information or clerical corrections are incorporated into the Provider Directory. As described in Attachment B-1, Section 7, during the Readiness Review, the HMO must develop and submit to HHSC the draft Provider Directory template for approval and must submit a final Provider Directory incorporating changes required by HHSC prior to the Operational Start Date. Such draft and final Provider Directories must be submitted according to the deadlines established in Attachment B-1, Section 7.
