Managed Care Technical Manual definition

Managed Care Technical Manual or “MCTM” A document developed by the Department that provides the technical specifications for the submission of encounters and other contract deliverables, including monthly, quarterly, annual, and other required reports from MCOs. In addition, it supplies technical information on enrollment and payment files, Department- generated files, and Departmental processes such as the processing of incarcerated members and the reconciliation of payments for newborn members.
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Examples of Managed Care Technical Manual in a sentence

  • This Contract includes the program requirements and specifications as outlined in RFP 2017-03, this Contract, and the Managed Care Technical Manual.

  • The Managed Care Technical Manual details the required reporting data elements.

  • The Contractor agrees to adhere to all additional reporting requirements related to the ▇▇▇▇▇▇ care and adoption assistance population, as outlined in the Managed Care Technical Manual.

  • Subcontracts which require the subcontractor to be responsible for the provision of covered services must include the terms set forth in the Managed Care Technical Manual and for the purposes of this Contract, that the subcontractor shall be considered both a subcontractor and network provider.

  • The Contractor shall submit its policies and procedures in accordance with the Managed Care Technical Manual.

  • The total number of calls received pertaining to patients in EDs needing assistance in accessing care in an alternative setting shall be tracked and reported as outlined in the Medallion 4.0 Managed Care Technical Manual.

  • The Contractor agrees to adhere to all additional reporting requirements related to the ▇▇▇▇▇▇ care population, as outlined in the Managed Care Technical Manual.

  • Subcontracts which require Vendor to be responsible for the provision of covered services must include the terms set forth in the Managed Care Technical Manual, that subcontractor shall be considered both a subcontractor and network provider Contractor shall adhere to subcontractor specific restrictions found herein Sections 13 and 14 of this Contract.

  • The Contractor must submit to the department an annual report detailing all efforts to engage key partners and establish community-based partnerships, in accordance with the Managed Care Technical Manual.

  • The Contractor’s advance directive written policies, procedures, and proof of staff education shall be submitted to the Department annually as outlined in the Managed Care Technical Manual.