Provider Services Function. The Contractor will operate a Provider Services function during regular business hours. At a minimum, the Contractor's Provider Services staff must be responsible for the following: a) Assisting providers with prior authorization and referral protocols. b) Assisting providers with claims payment procedures. c) Fielding and responding to provider questions and complaints.
Appears in 10 contracts
Samples: Contractor Agreement (Americhoice Corp), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
Provider Services Function. (A) The Contractor will shall operate a Provider Services services function during regular business hours. .
(B) At a minimum, Provider services staff shall be responsible for:
(1) training, including ongoing training, of the Contractor's Provider Services staff must be responsible for the following:
a) Assisting providers with prior authorization ’s Providers on Medicaid rules and referral protocols.
b) Assisting providers with claims payment procedures.
c) Fielding and responding regulations that shall enable Providers to provider questions and complaints.appropriately render services to Enrollees;
Appears in 5 contracts
Samples: Prepaid Mental Health Plan (Pmhp) Contract, Prepaid Mental Health Plan (Pmhp) Contract, Prepaid Mental Health Plan (Pmhp) Contract
Provider Services Function. a) The Contractor will operate a Provider Services function during regular business hours. At a minimum, the Contractor's Provider Services staff must be responsible for the following:
ai) Assisting providers with prior authorization and referral protocols.
bii) Assisting providers with claims payment procedures.
ciii) Fielding and responding to provider questions and complaints.
Appears in 2 contracts
Samples: Medicaid Managed Care Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Agreement (Amerigroup Corp)
Provider Services Function. The Contractor will operate a Provider Services function during regular business hours. At a minimum, the Contractor's Provider Services staff must be responsible for the following:
a) Assisting providers with prior authorization and referral protocols.
b) Assisting providers with claims payment procedures.
c) Fielding and responding to provider questions and complaints.. FHPlus - Section 21 (PARTICIPATING PROVIDERS) October 1, 2001 21-11
Appears in 1 contract
Samples: Consultant Services Agreement (Wellcare Health Plans, Inc.)
