MCO Administrative Services definition
MCO Administrative Services means the performance of services or functions, other than the direct delivery of Covered Services, necessary for the management of the delivery of and payment for Covered Services, including but not limited to Network, utilization, clinical and/or quality management, service authorization, claims processing, management information systems operation, and reporting. MCO’s Service Area means all the counties included in any HHSC-defined Service Area, as applicable to each MCO Program and within which the MCO has been selected to provide MCO services.
Examples of MCO Administrative Services in a sentence
This goal applies to MCO Administrative Services, as defined below.
The Respondent must submit an HSP (see the Procurement Library) with its proposal for such MCO Administrative Services.
MCO Administrative Services are those services or functions other than the direct delivery of medical Covered Services necessary to manage the delivery of and payment for such services.
MCO Administrative Services include but are not limited to Network, utilization, clinical and/or quality management, service authorization, claims processing, Management Information System (MIS) operation and reporting.
HHSC has determined that subcontracting opportunities are probable for this RFP for MCO Administrative Services.