State Licensure. Prior to the Contract effective date, and as verified in the readiness review described in Section 2.13, the Contractor must be an Indiana licensed accident or sickness insurer or an Indiana licensed health maintenance organization (HMO). The Contractor and all subcontractors shall use clinicians licensed by Indiana and follow all requirements contained within the Contract (e.g., PA/UM criteria; claims processing; encounter data submission; etc.), regardless of geographic location.
Appears in 10 contracts
Samples: Contract for Providing Risk Based Managed Care Services, Contract #0000000000000000000051705, Contract
State Licensure. Prior to the Contract effective date, and as verified in the readiness review described in Section 2.13review, the Contractor must be an Indiana be:
1. An Indiana-licensed accident or sickness insurer or an Indiana insurer; or
2. An Indiana-licensed health maintenance organization (HMO). The Contractor and all subcontractors shall use clinicians licensed by Indiana and follow all requirements contained within the Contract (e.g., PA/UM criteria; claims processing; encounter data submission; etc.), regardless of geographic location.
Appears in 3 contracts
Samples: Professional Services, Professional Services, Professional Services