Common use of ProviderWeb Portal Complaints Clause in Contracts

ProviderWeb Portal Complaints. The MCOP should check the ProviderWeb portal (hereinafter referred to as HealthTrack) complaint inbox daily for updates and new complaints assigned to them. 1. The MCOP shall acknowledge receipt of a HealthTrack complaint within 5 business days of the complaint’s submission by outreaching to the provider through an in-person visit, a phone call, or an email. If attempting to make contact via phone and the person is unavailable, a voicemail must be left. Outreach must include that the complaint was received and that the MCOP will respond by the assigned due date. 2. The MCOP shall document provider initial contact in HealthTrack within 6 business days of the complaint’s submission and including the following: a. The date(s) that outreach was made to the provider (a future date of contact will not be accepted); b. A call reference number if applicable; c. The method(s) of contact; d. The person that made the contact; and e. The name of the individual(s) contacted. 3. The MCOP shall perform internal research, contact the provider, and present its findings to the provider within 15 business days. 1. Provider Contact shall include: i. Outreach Monday through Friday between the hours of 8:00am and 5:00pm Eastern Standard Time; ii. The assigned provider representative’s contact information; iii. The HealthTrack complaint number or call reference number; and iv. The MCOP’s findings, including all relevant information, to ensure the provider is educated on how to access all supporting policies or procedures. 2. If the provider is non-responsive, prior to closure of the complaint, a minimum of three outreach attempts must be made to the provider by the MCOP. 3. The MCOP shall document the following in HealthTrack by the assigned due date: i. The date(s) contact was made, including all attempted contacts, with the provider (a future date of contact will not be accepted); ii. The method(s) of contact; iii. The name of the individual(s) contacted; iv. The findings shared with the provider; v. The policies and procedures to support the findings; vi. Root cause analysis or CPSE details; and vii. If already reported to ODM as a CPSE then the MCOP shall include the report month and row number. 4. If the MCOP requires additional time to research a provider complaint, the MCOP shall: i. Contact the provider, advise the provider of the delay in response, and indicate that the MCOP will ask ODM to grant an extension. ODM will not grant the MCOP an extension if the request does not include evidence that the MCOP contacted the provider; and ii. Document this outreach in HealthTrack, including the date of the provider contact, the name(s) of the individual(s) contacted, the requested extension date, and the justification for the delay in resolution. 5. ODM reserves the right to shorten the length of time the MCOP is allotted to address a complaint. ODM will enter a comment in HealthTrack advising the MCOP that the due date has been shortened.

ProviderWeb Portal Complaints. The MCOP MCP should check the ProviderWeb portal (hereinafter referred to as HealthTrack) complaint inbox daily for updates and new complaints assigned to them. 1. The MCOP MCP shall acknowledge receipt of a HealthTrack complaint within 5 business days of the complaint’s submission by outreaching to the provider through an in-person visit, a phone call, or an email. If attempting to make contact via phone and the person is unavailable, a voicemail must be left. Outreach must include that the complaint was received and that the MCOP MCP will respond by the assigned due date. 2. The MCOP MCP shall document initial provider initial contact in HealthTrack within 6 business days of the complaint’s submission and submission, including the following: a. The date(s) that outreach was made to the provider (a future date of contact will not be accepted); b. A call reference number if applicable; c. The method(s) of contact; d. The person that made the contact; and e. The name of the individual(s) contacted. 3. The MCOP MCP shall perform internal research, contact the provider, and present its findings to the provider within 15 business days. 1. a. Provider Contact shall include: i. Outreach Monday through Friday between the hours of 8:00am and 5:00pm Eastern Standard Time; ii. The assigned provider representative’s contact information; iii. The HealthTrack complaint number or call reference number; and iv. The MCOPMCP’s findings, including all relevant information, to ensure the provider is educated on how to access all supporting policies or procedures. 2. b. If the provider is non-responsive, prior to closure of the complaint, a minimum of three outreach attempts must be made to the provider by the MCOPMCP. 3. c. The MCOP MCP shall document the following in HealthTrack by the assigned due date: i. The date(s) contact was made, including all attempted contacts, with the provider (a future date of contact will not be accepted); ii. The method(s) of contact; iii. The name of the individual(s) contacted; iv. The findings shared with the provider; v. The policies and procedures to support the findings;; and vi. Root cause analysis or CPSE details; and vii. If already reported to ODM as a CPSE then the MCOP MCP shall include the report month and row number. 4. d. If the MCOP MCP requires additional time to research a provider complaint, the MCOP MCP shall: i. Contact the provider, advise the provider of the delay in response, and indicate that the MCOP MCP will ask ODM to grant an extension. ODM will not grant the MCOP MCP an extension if the request does not include evidence that the MCOP MCP contacted the provider; and ii. Document this outreach in HealthTrack, including the date of the provider contact, the name(s) of the individual(s) contacted, the requested extension date, and the justification for the delay in resolution. 5. e. ODM reserves the right to shorten the length of time the MCOP MCP is allotted to address a complaint. ODM will enter a comment in HealthTrack advising the MCOP MCP that the due date has been shortened.

ProviderWeb Portal Complaints. The MCOP MCP should check the ProviderWeb portal (hereinafter referred to as HealthTrack) complaint inbox daily for updates and new complaints assigned to them. 1. The MCOP MCP shall acknowledge receipt of a HealthTrack complaint within 5 business days of the complaint’s submission by outreaching to the provider through an in-person visit, a phone call, or an email. If attempting to make contact via phone and the person is unavailable, a voicemail must be left. Outreach must include that the complaint was received and that the MCOP MCP will respond by the assigned due date. 2. The MCOP MCP shall document initial provider initial contact in HealthTrack within 6 business days of the complaint’s submission and submission, including the following: a. The date(s) that outreach was made to the provider (a future date of contact will not be accepted); b. A call reference number if applicable; c. The method(s) of contact; d. The person that made the contact; and e. The name of the individual(s) contacted. 3. The MCOP MCP shall perform internal research, contact the provider, and present its findings to the provider within 15 business days. 1. a. Provider Contact shall include: i. Outreach Monday through Friday between the hours of 8:00am and 5:00pm Eastern Standard Time; ii. The assigned provider representative’s contact information; iii. The HealthTrack complaint number or call reference number; and iv. The MCOPMCP’s findings, including all relevant information, to ensure the provider is educated on how to access all supporting policies or procedures. 2. b. If the provider is non-responsive, prior to closure of the complaint, a minimum of three outreach attempts must be made to the provider by the MCOPMCP. 3. c. The MCOP MCP shall document the following in HealthTrack by the assigned due date: i. The date(s) contact was made, including all attempted contacts, with the provider (a future date of contact will not be accepted); ii. The method(s) of contact; iii. The name of the individual(s) contacted; iv. The findings shared with the provider; v. The policies and procedures to support the findings;; and vi. Root cause analysis or CPSE details; and vii. If already reported to ODM as a CPSE then the MCOP MCP shall include the report month and row number.row 4. d. If the MCOP MCP requires additional time to research a provider complaint, the MCOP MCP shall: i. Contact the provider, advise the provider of the delay in response, and indicate that the MCOP MCP will ask ODM to grant an extension. ODM will not grant the MCOP MCP an extension if the request does not include evidence that the MCOP MCP contacted the provider; and ii. Document this outreach in HealthTrack, including the date of the provider contact, the name(s) of the individual(s) contacted, the requested extension date, and the justification for the delay in resolution. 5. e. ODM reserves the right to shorten the length of time the MCOP MCP is allotted to address a complaint. ODM will enter a comment in HealthTrack advising the MCOP MCP that the due date has been shortened.

ProviderWeb Portal Complaints. The MCOP MCP should check the ProviderWeb portal (hereinafter referred to as HealthTrack) complaint inbox daily for updates and new complaints assigned to them. 1. The MCOP MCP shall acknowledge receipt of a HealthTrack complaint within 5 business days of the complaint’s submission by outreaching by: a. Outreaching to the provider through an in-person visit, a phone call, or an email. If attempting to make contact via phone and the person is unavailable, a voicemail must be left. Outreach must include that the complaint was received and that the MCOP MCP will respond by the assigned due date; and b. Documenting the MCP’s contact with the provider in HealthTrack. 2. The MCOP shall document provider initial contact in HealthTrack within 6 business days of the complaint’s submission and including the following: a. The date(s) that outreach was made to the provider (a future date of contact will not be accepted); b. A call reference number if applicable; c. The method(s) of contact; d. The person that made the contact; and e. The name of the individual(s) contacted. 3. The MCOP MCP shall perform internal research, contact the provider, and present its findings to the provider within 15 business daysprovider. 1. a. Provider Contact shall include: i. Outreach Monday through Friday between the hours of 8:00am and 5:00pm Eastern Standard Time; ii. The assigned provider representative’s contact information; iii. The HealthTrack complaint number or call reference number; and iv. The MCOPMCP’s findings, including all relevant information, to ensure the provider is educated on how to access all supporting policies or procedures. 2. If the provider is non-responsive, prior to closure of the complaint, a minimum of three outreach attempts must be made to the provider by the MCOP. 3. b. The MCOP MCP shall document the following in HealthTrack by the assigned due date: i. The date(s) contact was made, including all attempted contacts, made with the provider (a future date of contact will not be accepted); ii. The method(s) of contact; iii. The name of the individual(s) contacted; iv. The findings shared with the provider;; and v. The policies and procedures to support the findings; vi. Root cause analysis or CPSE details; and vii. If already reported to ODM as a CPSE then the MCOP shall include the report month and row number. 4. c. If the MCOP MCP requires additional time to research a provider complaint, the MCOP MCP shall: i. Contact the provider, advise the provider of the delay in response, and indicate that the MCOP MCP will ask ODM to grant an extension. ODM will not grant the MCOP MCP an extension if the request does not include evidence that the MCOP MCP contacted the provider; and ii. Document this outreach in HealthTrack, including the date of the provider contact, the name(s) of the individual(s) contacted, the requested extension date, and the justification for the delay in resolution. 5. d. ODM reserves the right to shorten the length of time the MCOP MCP is allotted to address a complaint. ODM will enter a comment in HealthTrack advising the MCOP MCP that the due date has been shortened.

ProviderWeb Portal Complaints. The MCOP MCP should check the ProviderWeb portal (hereinafter referred to as HealthTrack) complaint inbox daily for updates and new complaints assigned to them. 1. The MCOP MCP shall acknowledge receipt of a HealthTrack complaint within 5 business days of the complaint’s submission by outreaching to the provider through an in-person visit, a phone call, or an email. If attempting to make contact via phone and the person is unavailable, a voicemail must be left. Outreach must include that the complaint was received and that the MCOP MCP will respond by the assigned due date. 2. The MCOP MCP shall document initial provider initial contact in HealthTrack within 6 business days of the complaint’s submission and submission, including the following: a. The date(s) that outreach was made to the provider (a future date of contact will not be accepted); b. A call reference number if applicable; c. The method(s) of contact; d. The person that made the contact; and e. The name of the individual(s) contacted. 3. The MCOP MCP shall perform internal research, contact the provider, and present its findings to the provider within 15 business days. 1. a. Provider Contact shall include: i. Outreach Monday through Friday between the hours of 8:00am and 5:00pm Eastern Standard Time; ii. The assigned provider representative’s contact information; iii. The HealthTrack complaint number or call reference number; and iv. The MCOPMCP’s findings, including all relevant information, to ensure the provider is educated on how to access all supporting policies or procedures.policies 2. b. If the provider is non-responsive, prior to closure of the complaint, a minimum of three outreach attempts must be made to the provider by the MCOPMCP. 3. c. The MCOP MCP shall document the following in HealthTrack by the assigned due date: i. The date(s) contact was made, including all attempted contacts, with the provider (a future date of contact will not be accepted); ii. The method(s) of contact; iii. The name of the individual(s) contacted; iv. The findings shared with the provider; v. The policies and procedures to support the findings;; and vi. Root cause analysis or CPSE details; and vii. If already reported to ODM as a CPSE then the MCOP MCP shall include the report month and row number. 4. d. If the MCOP MCP requires additional time to research a provider complaint, the MCOP MCP shall: i. Contact the provider, advise the provider of the delay in response, and indicate that the MCOP MCP will ask ODM to grant an extension. ODM will not grant the MCOP MCP an extension if the request does not include evidence that the MCOP MCP contacted the provider; and ii. Document this outreach in HealthTrack, including the date of the provider contact, the name(s) of the individual(s) contacted, the requested extension date, and the justification for the delay in resolution. 5. e. ODM reserves the right to shorten the length of time the MCOP MCP is allotted to address a complaint. ODM will enter a comment in HealthTrack advising the MCOP MCP that the due date has been shortened.

ProviderWeb Portal Complaints. The MCOP should check the ProviderWeb portal (hereinafter referred to as HealthTrack) complaint inbox daily for updates and new complaints assigned to them. 1. The MCOP shall acknowledge receipt of a HealthTrack complaint within 5 business days of the complaint’s submission by outreaching to the provider through an in-person visit, a phone call, or an email. If attempting to make contact via phone and the person is unavailable, a voicemail must be left. Outreach must include that the complaint was received and that the MCOP will respond by the assigned due date. 2. The MCOP shall document provider initial contact in HealthTrack within 6 business days of the complaint’s submission and including the following: a. The date(s) that outreach was made to the provider (a future date of contact will not be accepted); b. A call reference number if applicable; c. The method(s) of contact; d. The person that made the contact; and e. The name of the individual(s) contacted. 3. The MCOP shall perform internal research, contact the provider, and present its findings to the provider within 15 business days. 1. a. Provider Contact shall include: i. Outreach Monday through Friday between the hours of 8:00am and 5:00pm Eastern Standard Time; ii. The assigned provider representative’s contact information; iii. The HealthTrack complaint number or call reference number; and iv. The MCOP’s findings, including all relevant information, to ensure the provider is educated on how to access all supporting policies or procedures. 2. b. If the provider is non-responsive, prior to closure of the complaint, a minimum of three outreach attempts must be made to the provider by the MCOP. 3. c. The MCOP shall document the following in HealthTrack by the assigned due date: i. The date(s) contact was made, including all attempted contacts, with the provider (a future date of contact will not be accepted); ii. The method(s) of contact; iii. The name of the individual(s) contacted; iv. The findings shared with the provider; v. The policies and procedures to support the findings; vi. Root cause analysis or CPSE details; and vii. If already reported to ODM as a CPSE then the MCOP shall include the report month and row number. 4. d. If the MCOP requires additional time to research a provider complaint, the MCOP shall: i. Contact the provider, advise the provider of the delay in response, and indicate that the MCOP will ask ODM to grant an extension. ODM will not grant the MCOP an extension if the request does not include evidence that the MCOP contacted the provider; and ii. Document this outreach in HealthTrack, including the date of the provider contact, the name(s) of the individual(s) contacted, the requested extension date, and the justification for the delay in resolution. 5. e. ODM reserves the right to shorten the length of time the MCOP is allotted to address a complaint. ODM will enter a comment in HealthTrack advising the MCOP that the due date has been shortened.

ProviderWeb Portal Complaints. The MCOP should check the ProviderWeb portal (hereinafter referred to as HealthTrack) complaint inbox daily for updates and new complaints assigned to them. 1. i. The MCOP shall acknowledge receipt of a HealthTrack complaint within 5 business days of the complaint’s submission by outreaching to the provider through an in-person visit, a phone call, or an email. If attempting to make contact via phone and the person is unavailable, a voicemail must be left. Outreach must include that the complaint was received and that the MCOP will respond by the assigned due date. 2ii. The MCOP shall document provider initial contact in HealthTrack within 6 business days of the complaint’s submission and including the following: a. The date(s) that outreach was made to the provider (a future date of contact will not be accepted); b. A call reference number if applicable; c. The method(s) of contact; d. The person that made the contact; and e. The name of the individual(s) contacted. 3iii. The MCOP shall perform internal research, contact the provider, and present its findings to the provider within 15 business days. 1. Provider Contact shall include: i. Outreach Monday through Friday between the hours of 8:00am and 5:00pm Eastern Standard Time; ii. The assigned provider representative’s contact information; iii. The HealthTrack complaint number or call reference number; and iv. The MCOP’s findings, including all relevant information, to ensure the provider is educated on how to access all supporting policies or procedures. 2. If the provider is non-responsive, prior to closure of the complaint, a minimum of three outreach attempts must be made to the provider by the MCOP. 3. The MCOP shall document the following in HealthTrack by the assigned due date: i. The date(s) contact was made, including all attempted contacts, with the provider (a future date of contact will not be accepted); ii. The method(s) of contact; iii. The name of the individual(s) contacted; iv. The findings shared with the provider; v. The policies and procedures to support the findings; vi. Root cause analysis or CPSE details; and vii. If already reported to ODM as a CPSE then the MCOP shall include the report month and row number. 4. If the MCOP requires additional time to research a provider complaint, the MCOP shall: i. Contact the provider, advise the provider of the delay in response, and indicate that the MCOP will ask ODM to grant an extension. ODM will not grant the MCOP an extension if the request does not include evidence that the MCOP contacted the provider; and ii. Document this outreach in HealthTrack, including the date of the provider contact, the name(s) of the individual(s) contacted, the requested extension date, and the justification for the delay in resolution. 5. ODM reserves the right to shorten the length of time the MCOP is allotted to address a complaint. ODM will enter a comment in HealthTrack advising the MCOP that the due date has been shortened.