Provider Education and Training. The Contractor must provide training to all contracted providers and their staff regarding the requirements of the Contract and special needs of its enrollees. The Contractor must conduct initial training within thirty (30) calendar days of executing a contract with a newly contracted provider. The Contractor must also conduct ongoing training which may include webinars and web-based tutorials, as deemed necessary by the Contractor or DHHR in order to ensure compliance with program standards and this Contract and meet the needs of providers. The Contractor must develop and submit the Provider Training Manual and Training Plan, including topics, schedule and languages spoken, to DHHR for initial review and approval at least thirty (30) calendar days prior to any scheduled trainings and as updated thereafter. DHHR may attend any training sessions specific to this Contract at its discretion. The Contractor must submit to DHHR a provider education and training approach within one hundred fifty (150) calendar days of the Operational Start Date. DHHR must have at least ten
Provider Education and Training. HMO must provide appropriate training to all network providers and provider staff in the providers' area of practice regarding the scope of benefits available and the THSteps program. Training must include THSteps benefits, the periodicity schedule for THSteps checkups and immunizations, and Comprehensive Care Program (CCP) services available under the THSteps program to Members under age 21 years. Providers must also be educated and trained regarding the requirements imposed upon the department and contracting HMOs under the Consent Decree entered in Frew x. MxXxxxxx, xx. al., Civil Action No. 3:93CV65, in the United States District Court for the Eastern District of Texas, Paris Division. Providers should be educated and trained to treat each THSteps visit as an opportunity for a comprehensive assessment of the Member.
Provider Education and Training. 2.7.4.1. The Contractor must:
2.7.4.1.1. Inform its Provider Network about its Covered Services and service delivery model;
2.7.4.1.2. Educate its Provider Network about its responsibilities for the integration and coordination of Covered Services;
2.7.4.1.3. Provide information about Grievances and Appeals policies, including about procedures and timeframes, to all providers and First Tier, Downstream, and Related Entities, per 42 C.F.R. § 438.414;
2.7.4.1.4. Inform its Provider Network about its quality improvement efforts and the Providers‘ role in such a program;
2.7.4.1.5. Inform its Provider Network about its policies and procedures, especially regarding in and out-of-network referrals;
2.7.4.1.6. Develop and provide continuing education programs for members of the Provider Network, including but not limited to:
2.7.4.1.6.1. Identification and management of depression and alcohol abuse
2.7.4.1.6.2. Identification of abuse and neglect of Enrollees; 2.
Provider Education and Training. The Contractor shall provide training to all Providers and their staff regarding the requirements of the contract and special needs of Members, including EPSDT services. The Contractor shall conduct initial training within thirty (30) calendar days of placing a newly contracted Provider on active status. The Contractor shall also conduct ongoing training as deemed necessary by the Contractor or the Division or as requested by the Provider to ensure compliance with program standards and the Contract. The Contractor shall develop and submit a Provider Training Manual and prospective Training Plan to the Division for review and approval initially and as updated prior to use. The Contractor will submit quarterly reports on the trainings conducted, topics covered, the number and positions of staff completing the trainings, and trainings planned in the subsequent quarter. The Contractor shall also conduct, in collaboration with the Division, a minimum of ten (10) MississippiCAN Workshops annually targeting Providers. The Division will notify the Contractor of the dates, times, and locations for workshops.
Provider Education and Training. HMO must provide appropriate training to all network providers and provider staff in the providers' area of practice regarding the scope of benefits available and the THSteps program. Training must include THSteps benefits, the periodicity schedule for THSteps checkups and immunizations, the required elements of a THSteps medical screen, providing or arranging for all required lab screening tests (including lead screening), and Comprehensive Care Program (CCP) services available under the THSteps program to Members under age 21 years. Providers must also be educated and trained regarding the requirements imposed upon the department and contracting HMOs under the Consent Decree entered in Frew vs. McKinney, et al., Civil Action No. 3: 93CV65, in txx Xnited States District Court for the Eastern District of Texas, Paris Division. Providers should be educated and trained to treat each THSteps visit as an opportunity for a comprehensive assessment of the Member. HMO must report provider education and training regarding THSteps in accordance with Article 7.4.4.
Provider Education and Training. 2.7.4.1. The Contractor must:
2.7.4.1.1. Inform its Provider Network about its Covered Services and service delivery model;
2.7.4.1.2. Educate its Provider Network about its responsibilities for the integration and coordination of Covered Services;
2.7.4.1.3. Provide information about Grievances and Appeals policies, including about procedures and timeframes, to all providers and First Tier, Downstream, and Related Entities, per 42 C.F.R. § 438.414;
2.7.4.1.4. Inform its Provider Network about its quality improvement efforts and the Providers’ role in such a program;
2.7.4.1.5. Inform its Provider Network about its policies and procedures, especially regarding in and out-of-network referrals, and accessibility and accommodations requirements, including as described in Section 2.9.1.1.3;
2.7.4.1.6. Develop and provide continuing education programs for, and ensure competencies of, One Care Plan staff with Enrollee engagement roles, Utilization Management or Service Authorization roles, or in leadership roles; Care Coordinators, Clinical Care Managers, and LTS Coordinators; members of the Provider Network; and other First Tier, Downstream, and Related Entities, including on the following topics:
2.7.4.1.6.1. Identification and management of depression and alcohol abuse
2.7.4.1.6.2. Identification of abuse and neglect of Enrollees; 2.
Provider Education and Training. The Contractor shall submit annually a comprehensive plan to ensure that all providers receive proper education and training regarding the Medallion 4.0 program to comply with this Contract and all applicable Federal and State requirements. In this submission, the contractor must include a copy of all provider training manuals and calendars for review and approval by the Department. The Contractor shall attend meetings and forums with providers (e.g., early intervention providers, community behavioral health providers, etc.), and other contracted MCOs as necessary, and at DMAS’ request, to resolve any identified issues. At a minimum, the Contractor shall develop educational and training programs that cover the following topics or issues: All Medallion 4.0 covered services, carved-out and enhanced services, policies, procedures, and any modifications to these items; Eligibility standards, eligibility verification, and benefits; The role of the enrollment broker regarding enrollment and disenrollment; Special needs of members in general that may affect access to and delivery of services, to include, at a minimum, transportation needs; Enrollee rights and responsibilities; Grievance and appeals procedures; Procedures for reporting fraud, waste, and abuse; References to Medicaid manuals, memoranda, and other related documents; Payment policies and procedures; Billing instructions which are in compliance with the Department’s encounter data submission requirements; and, Marketing practice guidelines and the responsibility of the provider when representing the Contractor. The Contractor shall submit annually a comprehensive plan to ensure that all providers qualified to provide EPSDT services have access to proper education and training regarding the EPSDT benefit to comply with this Contract and all applicable Federal and State requirements. In this submission, the contractor must include a copy of all provider training manuals and calendars for review and approval by the Department. The Contractor’s EPSDT educational and training program will include the required topics: Overview of the EPSDT benefit Eligibility criteria EPSDT screenings Diagnostic services Treatment services, including EPSDT Specialized Services Referrals Clinical trials Required services to support access Beneficiary outreach and communication Medical necessity Service authorization Utilization controls Secondary review Intersection of EPSDT ...
Provider Education and Training. HMO must provide appropriate training to all network providers and provider staff in the providers' area of practice regarding the scope of benefits available and the THSteps program. Training must include THSteps benefits, the periodicity schedule for THSteps checkups and immunizations, THE REQUIRED ELEMENTS OF A THSTEPS MEDICAL SCREEN, PROVIDING OR ARRANGING FOR ALL REQUIRED LAB SCREENING TESTS (INCLUDING LEAD SCREENING), and Comprehensive Care Program (CCP) services available under the THSteps program to Members under age 21 years. Providers must also be educated and trained regarding the requirements imposed upon the department and contracting HMOs under the Consent Decree entered in Frex xx. McKinney, et. Al., Civil Action No. 3:93CV65, in the United States District Court for the Eastern District of Texas, Paris Division. Providers should be educated and trained to treat each THSteps visit as an opportunity for a comprehensive assessment of the Member. HMO MUST REPORT PROVIDER EDUCATION AND TRAINING REGARDING THSTEPS IN ACCORDANCE WITH ARTICLE 7.4.4.
Provider Education and Training. HMO must provide appropriate training to all network providers and provider staff in the providers' area of practice regarding the scope of benefits available and the THSteps program. Training must include THSteps benefits, the periodicity schedule for THSteps checkups and immunizations, and services available under the THSteps program which are not available to all Medicaid recipients and are available to ensure that Members can comply with the periodicity schedule, including but not limited to transportation, dental check-ups, and El Paso Service Area HMO Contract
Provider Education and Training. A. Initial Training. The contractor shall ensure that all providers receive sufficient training regarding the managed care program in order to operate in full compliance with program standards and all applicable federal and State regulations. At a minimum, all providers shall receive initial training in managed care services, the contractor's policies and procedures, and information about the needs of enrollees with special needs. Ongoing training shall be provided as deemed necessary by either the contractor or the State in order to ensure compliance with program standards. Subjects for provider training shall be tailored to the needs of the contractor's plan's target groups. Listed below are some examples of topics for training:
1. Identification and management of polypharmacy.
2. Identification and treatment of depression among elderly people and people with disabilities.
3. Identification and treatment of alcohol/substance abuse.
4. Identification of abuse and neglect.
5. Coordination of care with long-term services, mental health and substance abuse providers, including instruction regarding policies and procedures for maintaining the centralized member record.
6. Skills to assist elderly people and people with disabilities in coping with loss.
7. Cultural sensitivity to providing health care to various ethnic groups.
