Common use of Provider Services Function Clause in Contracts

Provider Services Function. (A) The Contractor shall operate Provider Services function during regular business hours. (B) At a minimum, Provider Services staff shall be responsible for the following: (1) training, including ongoing training, of the Contractor’s Providers on CHIP rules and regulations that shall enable Providers to appropriately render services to Enrollees; (2) assisting Providers to verify whether an individual is enrolled with the Dental Plan; (3) assisting Providers with prior authorizations and referral protocols; (4) assisting Providers with claims payment procedures; and (5) Xxxxxxxx and responding to Provider questions and the Grievance and Appeals System.

Provider Services Function. (A) The Contractor shall operate Provider Services function during regular business hours. (B) At a minimum, Provider Services staff shall be responsible for the following: (1) training, including ongoing training, of the Contractor’s Providers on CHIP rules and regulations that shall enable Providers to appropriately render services to Enrollees; (2) assisting Providers to verify whether an individual is enrolled with the Dental Contractor’s Health Plan; (3) assisting Providers with prior authorizations and referral protocols; (4) assisting Providers with claims payment procedures; and (5) Xxxxxxxx and responding to Provider questions and the Grievance and Appeals System.