Provider Agreement Effective July 1, 2017 through June 30, 2018July 7th, 2017
FiledJuly 7th, 2017Purpose and Approach………………………………………………………………… 3 Inpatient Hospital……………………………………………………………................ 5 Behavioral Health……………………………………………………………………… 6 Emergency Department……………………………………………………………….. 7 Dental……………………………………………………………………….................. 8 Vision……………………………………………………………………….................. 9 Primary & Specialist Care………………………………………………….................. 10 Pharmacy……………………………………………………………………..……….. 11 DME…………………………………………………………………………………... 12 Deliveries………………………………………………………………………………. 13 Incomplete Rendering Provider Data…………………………………………………… 14 NPI Provider Number Usage Without Medicaid/Reporting Provider Numbers……. 15 Rejected Encounters……………………………………………………………………... 16 Acceptance Rate…………………………………………………………………………..Encounter Data Accuracy Study.........................................................................………. 17 18E ncounter Data Submission Procedures 20 Timeliness of Encounter Data 20 Encounter Submissions per Encounter Schedule 21