Common use of Provider Education and Outreach Clause in Contracts

Provider Education and Outreach. The Contractor shall provide ongoing education to its provider network on the Hoosier Healthwise program, as well as Contractor-specific policies and procedures. In addition to developing its own provider education and outreach materials, the Contractor shall be required to coordinate with OMPP-sponsored provider outreach activities upon request. The contractor shall provide a provider relations plan to include frequency of visits and outcomes from concerns identified, program education, claim issues, etc. The Contractor shall educate its contracted providers, including behavioral health providers, regarding provider requirements and responsibilities, the Contractor’s prior authorization policies and procedures, clinical protocols, member’s rights and responsibilities, claims submission process, claims dispute resolution process, program integrity, identifying potential fraud and abuse, pay-for-performance programs and any other information relevant to improving the services provided to the Contractor’s Hoosier Healthwise members. 5.7.1 Provider Communications Review and Approval All provider communication materials required in this section or otherwise developed by the Contractor shall be pre-approved by OMPP. The Contractor shall develop and include a Contractor-designated inventory control number on all provider communications, including letters, forms, bulletins and promotional, educational, training, informational or other outreach materials, with a date issued or date revised clearly marked. The purpose of this inventory control number is to facilitate OMPP’s review and approval of all provider communications and documentation of its receipt and approval of original and revised documents. The Contractor shall submit all provider communication materials designed for distribution to, or use by, contracted providers to OMPP for review and approval at least thirty (30) calendar days prior to use and distribution. The Contractor shall also submit any material changes to previously approved provider communication materials to OMPP for review and approval at least thirty (30) calendar days prior to use and distribution. The Contractor shall receive approval from OMPP prior to distribution or use of materials. OMPP’s decision regarding any communication materials is final. The Contractor shall include the State program logo(s) in their provider communication materials upon OMPP request. The Contractor shall not refer to or use the FSSA, OMPP or other state agency name or logo in its provider communications without prior written approval. The Contractor shall request in writing approval from OMPP for each desired reference or use at least thirty (30) calendar days prior to the reference or use. Any approval given for the FSSA, OMPP or other state agency name or logo is specific to the use requested, and shall not be interpreted as blanket approval. All OMPP-approved provider communication materials shall be available on the Contractor’s provider website within three (3) business days of distribution. The provider communication materials shall be organized online in a user-friendly, searchable format by communication type and subject. Any provider communications by a subcontractor to IHCP providers regarding the HIP program must comply with the provisions in the section, just as the contractor is required.

Provider Education and Outreach. The Contractor shall provide ongoing education to its provider network on the Hoosier Healthwise program, as well as Contractor-specific policies and procedures. In addition to developing its own provider education and outreach materials, the Contractor shall be required to coordinate with OMPP-sponsored provider outreach activities upon request. The contractor shall provide a provider relations plan to include frequency of visits visit s and outcomes from concerns identified, program education, claim issues, etc. The Contractor shall educate its contracted providers, including behavioral health providers, regarding provider requirements and responsibilities, the Contractor’s prior authorization policies and procedures, clinical protocols, member’s rights and responsibilities, claims submission process, claims dispute resolution process, program integrity, identifying potential fraud and abuse, pay-for-pay -for- performance programs and any other information relevant to improving the services provided to the Contractor’s Hoosier Healthwise members. 5.7.1 Provider Communications Review and Approval All provider communication materials required in this section or otherwise developed by the Contractor shall be pre-approved by OMPP. The Contractor shall develop and include a Contractor-designated inventory control number on all provider communications, including letters, forms, bulletins and promotional, educational, training, informational or other outreach materials, with a date issued or date revised clearly marked. The purpose of this inventory control number is to facilitate OMPP’s review and approval of all provider communications and documentation of its receipt and approval of original and revised documents. The Contractor shall submit all provider communication materials designed for distribution to, or use by, contracted providers to OMPP for review and approval at least thirty (30) calendar days prior to use and distribution. The Contractor shall also submit any material changes to previously approved provider communication materials to OMPP for review and approval at least thirty (30) calendar days prior to use and distribution. The Contractor shall receive approval from OMPP prior to distribution or use of materials. OMPP’s decision regarding any communication materials is final. The Contractor shall include the State program logo(s) in their provider communication materials upon OMPP request. The Contractor shall not refer to or use the FSSA, OMPP or other state agency name or logo in its provider communications without prior written approval. The Contractor shall request in writing approval from OMPP for each desired reference or use at least thirty (30) calendar days prior to the reference or use. Any approval given for the FSSA, OMPP or other state agency name or logo is specific to the use requested, and shall not be interpreted as blanket approval. All OMPP-approved provider communication materials shall be available on the Contractor’s provider website within three (3) business days of distribution. The provider communication materials shall be organized online in a user-friendly, searchable format by communication type and subject. Any provider communications by a subcontractor to IHCP providers regarding the HIP program must comply with the provisions in the section, just as the contractor is required.

Provider Education and Outreach. The Contractor shall provide ongoing education to its provider network on the Hoosier Healthwise program, as well as Contractor-specific policies and procedures. In addition to developing its own provider education and outreach materials, the Contractor shall be required to coordinate with OMPP-sponsored provider outreach activities upon request. The contractor shall provide a provider relations plan to include frequency of visits and outcomes from concerns identified, program education, claim issues, etc. The Contractor shall educate its contracted providers, including behavioral health providers, regarding provider requirements and responsibilities, the Contractor’s prior authorization policies and procedures, clinical protocols, member’s rights and responsibilities, claims submission process, claims dispute resolution process, program integrity, identifying potential fraud and abuse, pay-for-for- performance programs and any other information relevant to improving the services provided to the Contractor’s Hoosier Healthwise members. 5.7.1 Provider Communications Review and Approval All provider communication materials required in this section or otherwise developed by the Contractor shall be pre-approved by OMPP. The Contractor shall develop and include a Contractor-designated inventory control number on all provider communications, including letters, forms, bulletins and promotional, educational, training, informational or other outreach materials, with a date issued or date revised clearly marked. The purpose of this inventory control number is to facilitate OMPP’s review and approval of all provider communications and documentation of its receipt and approval of original and revised documents. The Contractor shall submit all provider communication materials designed for distribution to, or use by, contracted providers to OMPP for review and approval at least thirty (30) calendar days prior to use and distribution. The Contractor shall also submit any material changes to previously approved provider communication materials to OMPP for review and approval at least thirty (30) calendar days prior to use and distribution. The Contractor shall receive approval from OMPP prior to distribution or use of materials. OMPP’s decision regarding any communication materials is final. The Contractor shall include the State program logo(s) in their provider communication materials upon OMPP request. The Contractor shall not refer to or use the FSSA, OMPP or other state agency name or logo in its provider communications without prior written approval. The Contractor shall request in writing approval from OMPP for each desired reference or use at least thirty (30) calendar days prior to the reference or use. Any approval given for the FSSA, OMPP or other state agency name or logo is specific to the use requested, and shall not be interpreted as blanket approval. All OMPP-approved provider communication materials shall be available on the Contractor’s provider website within three (3) business days of distribution. The provider communication materials shall be organized online in a user-friendly, searchable format by communication type and subject. Any provider communications by a subcontractor to IHCP providers regarding the HIP program must comply with the provisions in the section, just as the contractor is required.