Special Needs Unit. A special dedicated unit within the PH-MCO’s and the EAP contractor’s organizational structure established to deal with issues related to Members with Special Needs. Start Date — The first date on which Recipients are eligible for medical services under this Agreement, and on which the PH-MCOs are operationally responsible and financially liable for the provision of Medically Necessary services to Recipients. Step Therapy — A form of automated Prior Authorization whereby one or more prerequisite medications, which may or may not be in the same drug class, must be tried first before a Step Therapy medication will be approved Stop-Loss Protection — Coverage designed to limit the amount of financial loss experienced by a Health Care Provider. Subcapitation — A fixed per capita amount that is paid by the PH-MCO to a Network Provider for each Member identified as being in their capitation group, whether or not the Member received medical services. Subcontract — Any contract between the PH-MCO and an individual, business, university, governmental entity, or nonprofit organization to perform part or all of the PH-MCO’s responsibilities under this Agreement. Exempt from this definition are salaried employees, utility agreements and Provider Agreements, which are not considered Subcontracts for the purpose of this Agreement and, unless otherwise specified herein, are not subject to the provisions governing Subcontracts. Sustained Improvement — Improvement in performance documented through continued measurement of quality indicators after the performance project/study/quality initiative is completed.
Special Needs Unit means, at a minimum, a bedroom contained within a unit of special needs housing for one or more occupants that contains a bed for each occupant and access to a bathroom.
Special Needs Unit. A special dedicated unit within the PH-MCO and the EAP broker’s organizational structure established to deal with issues related to Members with Special Needs. Start Date — The first date on which the PH-MCO is operationally responsible and financially liable for the provision of Medically Necessary services to Members. Step Therapy — A type of Prior Authorization requirement, sometimes referred to as a fail first requirement, intended as a cost savings that begins drug therapy with the most cost-effective drug therapy, and progresses to other more costly therapies determined to be Medically Necessary. Stop-Loss Protection — Coverage designed to limit the amount of financial loss experienced by a Health Care Provider. Subcapitation — A fixed per capita amount that is paid by the PH-MCO to a Network Provider for each Member identified as being in their capitation group, whether or not the Member received medical services. Subcontract — A contract between the PH-MCO and an individual, business, university, governmental entity, or nonprofit organization to perform part or all of Subcontractor — An individual or entity that has a contract a PH-MCO that relates directly or indirectly to the performance of the PH-MCO’s obligation under its contract with the Department. A network provider is not a Subcontractor by virtue of the network Provider Agreement with the MCO, PIHP, or PAHP. Sustained Improvement — Improvement in performance documented through continued measurement of quality indicators after the performance project, study, or quality initiative is complete.
Examples of Special Needs Unit in a sentence
The Special Needs Unit conducts the research and resolves the referral.
Some case reviews may end up as a referral if there is more research and follow-up required by the Special Needs Unit.
The PH-MCO must forward all calls received by the Member services area in which the caller requests the Special Needs Unit to the SNU.
A ‘case review’ is when the Special Needs Unit helps with questions from a choice counselor as they are on a call.
The Choice Counseling Special Needs Unit has primary responsibility for the health literacy function.
Entities might include but are not limited to the Act 150 program, the OPTIONS program or OMAP’s Special Needs Unit.
The Special Needs Unit has a Registered Nurse and a Licensed Practical Nurse who have both earned their choice counseling certification.
Summary of cases taken by the Special Needs UnitA ‘case referral’ is when a choice counselor refers a case to the Special Needs Unit through the choice counseling vendor’s enrollment system (Health Track) or verbally via phone transfer, for follow-up.
With mutual agreement between management and the employee, employees at the Riverside Special Needs Unit, including security staff, may flex their work schedules.
The Medical Director must be actively involved in all major clinical program components of the PH-MCO and directly participates in the oversight of the Special Needs Unit, QM Department and UM Department.
More Definitions of Special Needs Unit
Special Needs Unit. A special dedicated unit within the PH-MCO and the EAP broker’s organizational structure established to deal with issues related to Members with Special Needs. Start Date — The first date on which the PH-MCO is operationally responsible and financially liable for the provision of Medically Necessary services to Members. Step Therapy — A type of Prior Authorization requirement, sometimes referred to as a fail first requirement, intended as a cost savings that begins drug therapy with Stop-Loss Protection — Coverage designed to limit the amount of financial loss experienced by a Health Care Provider. Subcapitation — A fixed per capita amount that is paid by the PH-MCO to a Network Provider for each Member identified as being in their capitation group, whether or not the Member received medical services. Subcontract — A contract between the PH-MCO and an individual, business, university, governmental entity, or nonprofit organization to perform part or all of the PH-MCO’s responsibilities under this Agreement. Exempt from this definition are salaried employees, utility agreements and Provider Agreements, which are not considered Subcontracts for the purpose of this Agreement and, unless otherwise specified herein, are not subject to the provisions governing Subcontracts. Subcontractor — An individual or entity that has a contract a PH-MCO that relates directly or indirectly to the performance of the PH-MCO’s obligation under its contract with the Department. A network provider is not a Subcontractor by virtue of the network Provider Agreement with the MCO, PIHP, or PAHP. Sustained Improvement — Improvement in performance documented through continued measurement of quality indicators after the performance project, study, or quality initiative is complete.
Special Needs Unit. A special dedicated unit within the PH-MCO’s and the EAP contractor’s organizational structure established to deal with issues related to Members with Special Needs. Start Date — The first date on which Recipients are eligible for medical services under this Agreement, and on which the PH-MCOs are operationally responsible and financially liable for the provision of Medically Necessary services to Recipients. Step Therapy — A type of Prior Authorization requirement, sometimes referred to as a fail first requirement, intended as a cost savings that begins drug therapy with the most cost-effective drug therapy, and progresses to other more costly therapies determined to be medically necessary. Stop-Loss Protection — Coverage designed to limit the amount of financial loss experienced by a Health Care Provider. Subcapitation — A fixed per capita amount that is paid by the PH-MCO to a Network Provider for each Member identified as being in their capitation group, whether or not the Member received medical services. Subcontract — Any contract between the PH-MCO and an individual, business, university, governmental entity, or nonprofit organization to perform part or all of the PH-MCO’s responsibilities under this Agreement. Exempt from this definition are salaried employees, utility agreements and Provider Agreements, which are not considered Subcontracts for the purpose of this Agreement and, unless otherwise specified herein, are not subject to the provisions governing Subcontracts. Sustained Improvement — Improvement in performance documented through continued measurement of quality indicators after the performance project/study/quality initiative is completed.
Special Needs Unit means a single unit of special needs housing for one or more occupants that contains, at a minimum, a bedroom and a bathroom.
Special Needs Unit means a unit that has been exclusively established for mental health purposes for Inmates who suffer from a mental disorder and can function within a general population setting. Currently, there are three Special Needs units; one Maximum Security Facility located at North Branch Correctional Institution, one Medium Security Facility located at Roxbury Correctional Institution and one Pre-Trial Facility located at BCDC. The current units are identified in the column labeled “Pill Line at Mental Health Units” on Attachment N.
Special Needs Unit means a unit that has been exclusively established for mental health purposes. The current units are identified in the column labeled “Pill Line at Mental Health Units” on Attachment N.
Special Needs Unit or “SNU” means a unit that has been exclusively established for mental health purposes for Inmates who suffer from a mental disorder and can function within a general population setting. Currently, there are three Special Needs unit; one Maximum Security Facility located at North Branch Correctional Institution, one Medium Security Facility located at Roxbury Correctional Institution and one Pre-Trial Facility located at BCDC.