Provider Accessibility Clause Samples
The PROVIDER ACCESSIBILITY clause defines the requirements and standards for ensuring that the provider’s services, products, or facilities are accessible to all users, including those with disabilities. This may involve compliance with specific accessibility laws or guidelines, such as the Americans with Disabilities Act (ADA) or Web Content Accessibility Guidelines (WCAG), and could require the provider to make reasonable accommodations or modifications to their offerings. The core function of this clause is to promote inclusivity and prevent discrimination by ensuring that all individuals have equal access to the provider’s services.
Provider Accessibility. The Contractor shall implement policies and procedures related to network provider accessibility. This shall include establishing timeliness standards for scheduling appointments based on provider type and the urgency of the member’s need (e.g., routine or urgent) and maximum in-office wait times. These standards shall be submitted to the State for review and approval. Additionally, Respondents shall propose methods for monitoring these requirements.
Provider Accessibility. 7.1.1 HMO must enter into written contracts with properly credentialed health care service providers. The names of all providers must be submitted to TDH as part of HMO subcontracting process. HMO must have its own credentialing process to review, approve and periodically recertify the credentials of all participating providers in compliance with 28 TAC 11.1902, relating to credentialing of providers in HMOs.
7.1.2 HMO must require tax I.D. numbers from all providers. HMO is required to do backup withholding from all payments to providers who fail to give tax I.D. numbers or who give incorrect numbers.
Provider Accessibility. Participating Provider shall provide call coverage or other back-up to provide service in accordance with Carolina Complete’s standards for provider accessibility addressed set forth herein, in the Provider Manual and/or in the State Contract. (Section VII, G(1)(i)). Participating Provider agrees to meet the NC DHHS standards for timely access to care and services, taking into account the urgency of need for services. (Section V, D(1)(d)(ii)). Participating Provider shall provide physical access, reasonable accommodations, including parking, exam and waiting rooms, and accessible equipment for Medicaid Covered Persons with physical or mental disabilities. (Section V, (1)(d)(vi)).
Provider Accessibility. CONTRACTOR is required to meet the TDI accessibility and availability requirements and the TDI services requirements for HMOs (Title 28, Part I, Chapter 11, Subchapters Q and U of the Texas Administrative Code). Out-of-network and emergency services also must be provided in accordance with the Texas Insurance Code and TDI regulations as they apply to HMOs. CONTRACTOR must have a sufficient number of providers (including pediatric providers) to meet Members' needs in accordance with TDI accessibility and availability requirements. PCPs and specialty care providers with experience in treating children and adolescents must be available to all Members . CONTRACTOR must ensure that CCSHCN have access to treatment by a multidisciplinary team when determined to be medically necessary for effective treatment or to avoid separate and fragmented evaluations and service plans. The teams must include both physician and non-physician providers determined to be necessary by the Member's PCP. CONTRACTOR must assure access to Texas Department of Health (TDH)-designated Level I and Level II trauma centers within the State or hospitals meeting the equivalent level of trauma care, for emergency services only. CONTRACTOR may make out-of-network reimbursement arrangements with the TDH-designated Level I and Level II trauma centers. CONTRACTOR must assure adequate access of all Members to children's hospitals and pediatric health care centers with recognized special expertise in the care of CCSHCN to meet the medically necessary referrals of a PCP as documented in the Member's medical record. TDH-approved pediatric transplant centers and federally qualified hemophilia centers are examples. CONTRACTOR may make out-of-network reimbursement arrangements for treatment in these hospitals or centers.
Provider Accessibility. Provider shall arrange for call coverage or other back-up to provide service in accordance with Tailored Plan's standards for provider accessibility. Provider will in addition:
i. Offer hours of operation that are no less than the hours of operation offered to commercial enrollees or comparable to NC Medicaid Direct, if Provider serves only Medicaid beneficiaries;
ii. Make Covered Services available to Covered Persons twenty-four (24) hours a day, seven (7) days a week, including holidays, when medically necessary; and
iii. Have a “no-reject policy” for referrals within the capacity and parameters of Provider’s competencies. Provider agrees to accept all referrals meeting criteria for Covered Services that it provides when there is available capacity. (Section VII. Attachment G.1.1(i) p 80)
Provider Accessibility. PO shall provide call coverage or other back-up to ensure coverage of service in accordance with the BH I/DD Tailored Plan's standards for provider accessibility, in the Provider Manual, and/or in the State Contract. This shall include provision of rendering services included in the contract available 24 hours a day, 7 days a week, including holidays, when medically necessary. PO agrees to meet the NC DHHS standards for timely access to care and services, considering the urgency of need for services. PO shall have a “no-reject policy” for referrals within the capacity and parameters of their competencies. PO shall accept all referrals meeting criteria for services they provide when there is available capacity.
Provider Accessibility. 7.1.1 HMO must enter into written contracts with properly credentialed health care service providers. The names of all providers must be submitted to TDH as part of HMO subcontracting process. HMO must have its own credentialing process to review, approve and periodically recertify the credentials of all participating 54 Dallas Service Area Contract 61 providers in compliance with 28 TAC 11.1902, relating to credentialing of providers in HMOs.
7.1.2 HMO must require tax I.D. numbers from all providers. HMO is required to do backup withholding from all payments to providers who fail to give tax I.D. numbers, or who give incorrect numbers.
Provider Accessibility