Quality; Utilization Management. Provider shall cooperate with Subcontractor and Health Plan's peer review, grievance, quality improvement program and utilization management activities, and recognizes that Health Plan or its subcontractor will provide monitoring and oversight of Provider, including monitoring of services rendered to Covered Persons as agreed upon between Subcontractor, Health Plan and Provider based on services provided. If Health Plan has delegated credentialing to Provider, Provider shall ensure that all licensed medical professionals are credentialed in accordance with Health Plan’s and the Agency’s credentialing requirements as set forth in the State Contract.
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Samples: Florida LTC Medicaid Program Regulatory Requirements Appendix, Florida LTC Medicaid Program Regulatory Requirements Appendix, Provider Agreement
Quality; Utilization Management. Provider shall cooperate with Subcontractor and Health Plan's peer review, grievance, quality improvement program and utilization management activities, and recognizes that Health Plan or its subcontractor will provide monitoring and oversight of Provider, including monitoring of services rendered to Covered Persons as agreed upon between Subcontractor, Health Plan and Provider based on services providedPersons. If Health Plan has delegated credentialing to Provider, Provider shall ensure that all licensed medical professionals are credentialed in accordance with Health Plan’s and the Agency’s credentialing requirements as set forth in the State Medicaid Contract.
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