Timeliness of Access to Care. In accordance with 42 CFR §438.206(c)(1)(i), the MCO must have standards for timeliness of access to care and enrollee services that take into account the urgency of the need for services and that meet or exceed such standards as may be established by BMS. In accordance with 42 CRF §438.206(c), the MCO must also regularly monitor its provider network’s compliance with these standards, and take corrective action as necessary. Current BMS standards for timeliness state that: Emergency cases must be seen immediately or referred to an emergency facility; Urgent cases must be seen within forty-eight (48) hours; Routine cases other than clinical preventive services, must be seen within twenty-one
Appears in 2 contracts
Samples: Model Purchase of Service Provider Agreement, Service Provider Agreement
Timeliness of Access to Care. In accordance with 42 CFR §438.206(c)(1)(i), the MCO must have standards for timeliness of access to care and enrollee services that take into account the urgency of the need for services and that meet or exceed such standards as may be established by BMS. In accordance with 42 CRF §438.206(c), the MCO must also regularly monitor its provider network’s compliance with these standards, and take corrective action as necessary. Current BMS standards for timeliness state that: • Emergency cases must be seen immediately or referred to an emergency facility; • Urgent cases must be seen within forty-eight (48) hours; • Routine cases other than clinical preventive services, must be seen within twenty-one
Appears in 1 contract
Timeliness of Access to Care. In accordance with 42 CFR §438.206(c)(1)(i), the MCO must have standards for timeliness of access to care and enrollee services that take into account the urgency of the need for services and that meet or exceed such standards as may be established by BMSDHHR. In accordance with 42 CRF §438.206(c), the MCO must also regularly monitor its provider network’s compliance with these standards, and take corrective action as necessary. Current BMS DHHR standards for timeliness state that: Emergency cases must be seen immediately or referred to an emergency facility; Urgent cases must be seen within forty-eight (48) hours; Routine cases other than clinical preventive services, must be seen within twenty-one
Appears in 1 contract
Samples: Service Provider Agreement
