Common use of Provider Monitoring Clause in Contracts

Provider Monitoring. The Contractor’s system shall support monitoring and tracking of provider/enrollee grievances and appeals from receipt to disposition. The system shall be able to produce provider reports for quality of medical, behavioral, dental and MLTSS service analysis, flag and identify providers with restrictive conditions (e.g., fraud monitoring), and identify the confidentiality level of information (i.e., to manage who has access to the information).

Provider Monitoring. The Contractor’s contractor's system shall support monitoring and tracking of provider/enrollee complaints, grievances and appeals from receipt to disposition. The system shall be able to produce provider reports for quality of medical, behavioral, medical and dental and MLTSS service care analysis, flag and identify providers with restrictive conditions (e.g., fraud monitoring), and identify the confidentiality level of information (i.e., to manage who has access to the information).

Provider Monitoring. The Contractor’s system shall support monitoring and tracking of provider/enrollee complaints, grievances and appeals from receipt to disposition. The system shall be able to produce provider reports for quality of medical, behavioral, dental and MLTSS service analysis, flag and identify providers with restrictive conditions (e.g., fraud monitoring), and identify the confidentiality level of information (i.e., to manage who has access to the information).

Provider Monitoring. The Contractorcontractor’s system shall support monitoring and tracking of provider/enrollee complaints, grievances and appeals from receipt to disposition. The system shall be able to produce provider reports for quality of medical, behavioral, medical and dental and MLTSS service care analysis, flag and identify providers with restrictive conditions (e.g., fraud monitoring), and identify the confidentiality level of information (i.e., to manage who has access to the information).