Provider Termination Report Sample Clauses
Provider Termination Report. HMO must submit a monthly report which identifies any providers who cease to participate in HMO's provider network, either voluntarily or involuntarily. The report must be submitted to TDH in the format specified by TDH. HMO will submit the report no later than thirty (30) days after the end of the reporting month. The information must include the provider's name, Medicaid number, the reason for the provider's termination, and whether the termination was voluntary or involuntary.
Provider Termination Report. HMO must also include in the Provider Network Change Report information identifying any providers who cease to participate in HMO's provider network, either voluntarily or involuntarily. The information must include the provider's name, Medicaid number, the reason for the provider's termination, and whether the termination was voluntary or involuntary.