Secure Member Portal. The MCO must develop a secure member portal that allows members to perform the following functions: Submit questions, comments, grievances, and appeals; and receive a response, giving the member the option of requesting a response by return email or phone call; Submit changes of member name, address, and phone number for the MCO to provide that information to the County; and Request a change in PCP. The MCO must respond to questions or comments received from members within one business day from receipt. The MCO must offer members the option to "opt in" to receive information from the MCO via email or text message. The MCO must develop a secure member portal that allows members to access the following information: Authorized services; The member's current PCP; The data specified in 42 CFR 438.242 and 42 CFR 431.60; Explanation of benefits for MCO, SPBM, and OhioRISE claims; Community resources; and Other Information that the MCO determines would be helpful to encourage the member to engage in their own health care.
Appears in 4 contracts
Samples: Ohio Medicaid Provider Agreement for Managed Care Organization, Ohio Medicaid Provider Agreement for Managed Care Organization, Ohio Medicaid Provider Agreement for Managed Care Organization
Secure Member Portal. 1. The MCO must develop a secure member portal that allows members to perform the following functions: Submit questions, comments, grievances, and appeals; and receive a response, giving the member the option of requesting a response by return email or phone call; Submit changes of member name, address, and phone number for the MCO to provide that information to the County; and Request a change in PCPand
2. The MCO must respond to questions or comments received from members within one business day from receipt.
3. The MCO must offer members the option to "opt in" to receive information from the MCO via email or text message.
4. The MCO must develop a secure member portal that allows members to access the following information: Authorized services; The member's current PCP; The data specified in 42 CFR 438.242 and 42 CFR 431.60; Explanation of benefits for MCO, SPBM, and OhioRISE claims; Community resources; and Other Information that the MCO determines would be helpful to encourage the member to engage in their own health care.
Appears in 1 contract
Samples: Ohio Medicaid Provider Agreement
