Provider Rosters Sample Clauses

Provider Rosters. Provider hereby authorizes DCE and CMS to include Provider’s name and the name and likeness or photograph of each of its Practice Providers, and their office addresses, telephone numbers, credentials, areas of practice and willingness to accept new patients, in any roster of providers utilized by DCE or CMS including without limitation, those used for marketing and advertising purposes or with Beneficiaries or prospective Beneficiaries. Provider acknowledges and agrees that DCE shall be required to publicly report information regarding DCE’s organizational structure, including identifying the Provider.
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Provider Rosters. ‌ IHP agrees that its IHP Participants and providers will remain as listed on the Roster reported to the STATE each quarter, except that: IHP may modify IHP Participant National Provider Identifiers (NPIs), locations, clinics, specialties, groups of providers, or add individual Primary Care Providers or Specialty Providers to its Roster by the last day of each calendar quarter. IHP may add non- Participant locations, clinics, specialties, regional health systems, or groups of providers only by amending section 13.4, and section , as applicable, pursuant to section 11.5. Any changes to processes for maintaining provider Rosters and corresponding impacts to Attribution will be discussed with the IHP, and at least ninety (90) days’ notice will be provided to the IHP. Any changes to the provider Roster that result in a significant change in the population attributed to the IHP may result in discussions of the impacted terms of contract such as but not limited to payment. An IHP may designate on its Roster whether a provider serves as a Primary Care Provider (“PCP”) or Specialty Provider (“SPE”) in its organization. In absence of this designation, the provider’s primary taxonomy code will be used to categorize the provider according to the table below. If neither a PCP / SPE designation nor a primary taxonomy code is included on the Roster, the primary taxonomy code for that provider from the National Plan and Provider Enumeration System (NPPES) file will be used to categorize the provider according to the table below. A provider taxonomy not listed in this attachment will be considered a Specialty Provider, unless the IHP has otherwise designated the provider as a “PCP” on their Roster. Mapping Definitions from the NUCC Database Download can be found in Appendix 1, Provider Taxonomy, on the IHP website. Statutory Eligibility.‌ IHP warrants that it is eligible to participate in the demonstration consistent with Minnesota Statutes, § 256B.0755, in that it and/or its Participants has or will: Establish processes to monitor and ensure the quality of care provided; Provide or coordinate the full scope of primary care, and adopt methods of care delivery so that the full scope of primary care is provided and care is coordinated across the spectrum of services provided; Contract and/or coordinate with necessary providers and clinics for the delivery of care; and contract or form partnerships with community-based organizations and public health resources; Develop and u...
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Related to Provider Rosters

  • Provider Network The Panel of health service Providers with which the Contractor contracts for the provision of covered services to Members and Out-of-network Providers administering services to Members.

  • Provider Credentialing Contractor shall perform, or may delegate activities related to, credentialing and re-credentialing Participating Providers in accordance with a process reviewed and approved by State Regulators.

  • Provider Services The Contractor’s system shall collect, process, and maintain current and historical data on program providers. This information shall be accessible to all parts of the MCMIS for editing and reporting.

  • PROVIDER PERSONNEL 9.1 The Department and Provider agree and acknowledge that in the event of the Provider ceasing to provide the Services or part of them for any reason, Clause 25 (Re-Provision of the Services) of the Agreement will apply.

  • Provider Manual The Provider Manual shall be a comprehensive online reference tool for the Provider and staff regarding, but not limited to, administrative, prior authorization, and referral processes, claims and encounter submission processes, continuity of care requirements, and plan benefits. The Provider Manual shall also address topics such as clinical practice guidelines, availability and access standards, care management programs and Enrollee rights.

  • Provider If the Provider is a State Agency, the Provider acknowledges that it is responsible for its own acts and deeds and the acts and deeds of its agents and employees. If the Provider is not a State agency, then the Provider agrees to indemnify and save harmless the State and its officers and employees from all claims and liability due to activities of itself, its agents, or employees, performed under this contract and which are caused by or result from error, omission, or negligent act of the Provider or of any person employed by the Provider. The Provider shall also indemnify and save harmless the State from any and all expense, including, but not limited to, attorney fees which may be incurred by the State in litigation or otherwise resisting said claim or liabilities which may be imposed on the State as a result of such activities by the Provider or its employees. The Provider further agrees to indemnify and save harmless the State from and against all claims, demands, and causes of action of every kind and character brought by any employee of the Provider against the State due to personal injuries and/or death to such employee resulting from any alleged negligent act by either commission or omission on the part of the Provider.

  • Providers Services performed by a provider who has been excluded or debarred from participation in federal programs, such as Medicare and Medicaid. To determine whether a provider has been excluded from a federal program, visit the U.S. Department of Human Services Office of Inspector General website (xxxxx://xxxxxxxxxx.xxx.xxx.xxx/) or the Excluded Parties List System website maintained by the U.S. General Services Administration (xxxxx://xxx.xxx.gov/). • Services provided by facilities, dentists, physicians, surgeons, or other providers who are not legally qualified or licensed, according to relevant sections of Rhode Island Law or other governing bodies, or who have not met our credentialing requirements. • Services provided by a non-network provider, unless listed as covered in the Summary of Medical Benefits. • Services provided by naturopaths, homeopaths, or Christian Science practitioners.

  • Provider Directory a. The Contractor shall make available in electronic form and, upon request, in paper form, the following information about its network providers:

  • Provider Selection To the extent applicable to Provider in performance of the Agreement, Provider shall comply with 42 CFR 438.214, as may be amended from time to time, which includes, but is not limited to the selection and retention of providers, credentialing and recredentialing requirements and nondiscrimination. If Subcontractor and/or Health Plan delegate credentialing to Provider, Subcontractor and/or Health Plan will provide monitoring and oversight and Provider shall ensure that all licensed medical professionals are credentialed in accordance with Health Plan’s and the State Contract’s credentialing requirements.

  • Credentialing The Provider will maintain written documentation confirming that each individual providing services under this agreement has and maintains the requisite credentials. Any change in status regarding any credentialing requirements must be reported in writing, by the Provider to the Department's Credentialing Contracted Agent, within thirty days.

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