Provider Satisfaction Survey. The MCO is required to design, develop, and implement an annual provider satisfaction survey to evaluate provider or provider staff satisfaction with the MCO. The MCO must collect, analyze, and submit provider survey results to BMS on an annual basis. The survey must be submitted to prior to the conclusion of the contracting period of each Contract year, June 30th.
Provider Satisfaction Survey. The CONTRACTOR shall conduct at least one (1) annual Provider Satisfaction Survey that covers Contract Providers and follows NCQA guidelines to the extent applicable. The CONTRACTOR shall provide results to HCA as directed by the HCA CONTRACTOR shall also make a summary of the results available to interested parties. The CONTRACTOR shall have mechanisms in place to incorporate results in the CONTRACTOR’s QM/QI plan and Population Health Management plan for program and systems improvements. Practice Guidelines The CONTRACTOR shall: Adopt practice guidelines that meet the following requirements: Are based on valid and reliable clinical evidence or a consensus of health care professionals in the particular field; Consider the needs of the Members; Are adopted in consultation with Contract Providers; and Are reviewed and updated every two (2) years. Disseminate the guidelines to all affected Contract Providers and, upon request, to Members; and Ensure that decisions for Utilization Management, Member education, coverage of services, and other applicable areas are consistent with the guidelines. Performance Measures (PMs) All PMs and targets shall be based on HEDIS technical specifications for the current reporting year. In the event that NCQA alters the measure or technical specifications for the PMs listed, the CONTRACTOR will follow relevant and current NCQA standards. PMs and targets shall be reasonable and based on industry standards that are applicable to substantially similar populations. The CONTRACTOR shall meet performance targets specified by HCA. The PMs will be revised to meet HCA designated targets for Calendar Year (CY) 2024, 2025, and 2026. The CONTRACTOR will be required to collect, track, trend, and report PMs quarterly as directed by HCA and/or its designee. The CONTRACTOR shall provide quality data and other relevant information as requested to HCA/or its designee. Reporting elements and data are to be provided to HCA in the same format as the template provided by HCA as directed by HCA. The reporting period is based upon one (1) quarter of a Calendar Year (e.g., Q1 Total= January –March) and data is to be reported cumulatively as follows: Quarter 1 (Q1) = January – March, Quarter 2 (Q2) = January – June, Quarter 3 (Q3) = January – September, and Quarter 4 (Q4) = January – December. For the measurement period and reporting elements for each measure, please refer to the relevant technical specifications. The report must be submitted within tw...
Provider Satisfaction Survey. The Contractor shall conduct annual Provider satisfaction surveys. The Contractor must submit to the Division for review and approval, the survey questions and methodology by March 1 for the current calendar year. The results of the survey and action plans derived from these results must be filed with the Division at least ninety (90) calendar days following the completion of the survey and no later than December 1 for the current calendar year.
Provider Satisfaction Survey. The Health Plan shall submit a Provider satisfaction survey plan, including the questions to be asked, to the Agency for written approval by the end of the eighth (8th) month of this Contract. The Health Plan shall conduct the survey at the end of the first (1st) year of this Contract. The results of the Provider satisfaction survey shall be reported to the Agency within four (4) months of the beginning of the second year of this Contract.
Provider Satisfaction Survey. The Contractor shall conduct a provider satisfaction survey every other year. The survey shall include a statistically valid sample of its participating Medicaid providers. The Contractor shall submit a copy of the survey instrument and methodology to the Department. The Contractor shall communicate the findings of the survey to the Department in writing within one hundred twenty (120) days after conducting the survey. The written report shall also include identification of any corrective measures that need to be taken by the Contractor as a result of the findings, a time frame in which such corrective action will be taken by the Contractor and recommended changes as needed for subsequent use. Results of the survey shall be submitted biennially. PROVIDER PAYMENT PROCESSING In accordance with Section 1932(f) of the Social Security Act (42 U.S.C. § 1396a-2), the Contractor shall pay all in-and out-of-network providers on a timely basis, consistent with the claims payment procedure described in 42 C.F.R. §§ 447.45, 447.46, 438.60, and Section 1902 (a)(37), upon receipt of all clean claims for covered services rendered to covered members who are enrolled with the Contractor. The Contractor must ensure that the date of receipt is the date the Contractor receives the claim, as indicated by its date stamp on the claim; and that the date of payment is the date of the check or other form of payment. 42 C.F.R. § 447.45 defines timely processing of claims as: • Adjudication (pay or deny) of ninety percent (90%) of all clean Medallion 4.0 claims within thirty (30) calendar days of the date of receipt. • Adjudication (pay or deny) of ninety-nine percent (99%) of all Medallion 4.0 clean claims within ninety (90) calendar days of the date of receipt. • Adjudication (pay or deny) all other claims within twelve (12) months of the date of receipt. (See 42 C.F.R. § 447.45 for timeframe exceptions.) This requirement shall not apply to network providers who are not paid by the Contractor on a fee-for- service basis and will not override any existing negotiated payment scheduled between the Contractor and its providers. The Following exceptions shall apply: • Clean claims from community mental health rehabilitation services providers, ARTS and early intervention providers shall be processed within fourteen (14) calendar days of receipt of the clean claim. • Community behavioral health, early intervention, and ARTS providers shall be paid no less than the current Medicaid FFS ra...
Provider Satisfaction Survey. Contractor shall conduct annual provider satisfaction surveys. Contractor must submit the survey questions and methodology to DOM for review and approval by February first (1st) for the current calendar year. The results of the survey and action plans derived from these results must be filed with DOM at least ninety (90) calendar days following the completion of the survey and no later than June thirtieth (30th) for the current calendar year.
Provider Satisfaction Survey. Report Provider satisfaction with program areas such as claims submission and payment, assistance from MCO, communication, etc. This survey shall be developed by MCO and approved by DMA prior to use. The MCO shall use statewide standardized measures in addition to local measures.
Provider Satisfaction Survey. The CONTRACTOR shall conduct at least one (1) annual Provider Satisfaction Survey that covers Contract Providers and follows NCQA guidelines to the extent applicable. Results will be provided to HSD as directed by HSD. The CONTRACTOR shall also make a summary of the results available to interested parties. The CONTRACTOR shall have mechanisms in place to incorporate results in the QM/QI plan for program and systems improvements.
Provider Satisfaction Survey. Report Provider satisfaction with program areas such as claims submission and payment, assistance from the LME, communication, etc. This survey shall be developed by the LME and approved by DMA prior to use.
Provider Satisfaction Survey. The Contractor shall conduct a provider satisfaction survey every other year. The survey shall include a statistically valid sample of its participating Medicaid providers. The Contractor shall submit a copy of the survey instrument and methodology to the Department. The Contractor shall communicate the findings of the survey to the Department in writing within one hundred twenty (120) days after conducting the survey. The written report shall also include identification of any corrective measures that need to be taken by the Contractor as a result of the findings, a time frame in which such corrective action will be taken by the Contractor and recommended changes as needed for subsequent use. Results of the survey shall be submitted biennially.
