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.

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.

Provider Education and Outreach. The Contractor shall provide ongoing education to its provider network on the Hoosier Healthwise and HIP 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 HIP members.