PROVIDER INFORMATION AND PROCESSING REQUIREMENTS Clause Samples

The "Provider Information and Processing Requirements" clause defines the obligations of a service provider regarding the collection, handling, and processing of information, typically personal or sensitive data, in the course of providing services. It usually outlines the types of information the provider must collect, the standards or procedures for processing this data, and any compliance requirements with applicable laws or client instructions. For example, the clause may require the provider to implement specific security measures or restrict data use to certain purposes. Its core function is to ensure that information is managed responsibly and in accordance with legal and contractual standards, thereby protecting both the client and the data subjects involved.
PROVIDER INFORMATION AND PROCESSING REQUIREMENTS. A. Provider Data. The Contractor shall maintain individual and group provider network information with basic demographics, EIN or tax identification number, professional credentials, license and/or certification numbers and dates, sites, risk arrangements (i.e., individual and group risk pools), services provided, payment methodology and/or reimbursement schedules, group/individual provider relationships, facility linkages, and number of grievances. For PCPs, the Contractor shall maintain identification as traditional or safety net provider, specialties, enrollees with beginning and ending effective dates, capacity, emergency arrangements or contact, other limitations or restrictions, languages spoken, address, office hours, disability access. See Articles 4.8 and 5. The Contractor shall maintain provider history files and provide for easy data retrieval. The system should maintain audit trails of key updates. Providers should be identified with a unique number. The Contractor shall be able to cross- reference its provider number with the provider’s EIN, tax number, the provider’s license number, Unique Personal Identification Number (UPIN), National Provider Identifier, Medicaid provider number, Medicare provider number, and Social Security Number where applicable. The Contractor shall comply with HIPAA requirements for provider identification.
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PROVIDER INFORMATION AND PROCESSING REQUIREMENTS. A. Provider Data. The contractor shall maintain individual and group provider network information with basic demographics, EIN or tax identification number, professional credentials, license and/or certification numbers and dates, sites, risk arrangements (i.e., individual and group risk pools), services provided, payment methodology and/or reimbursement schedules, group/individual provider relationships, facility linkages, number of grievances and/or complaints. For PCPs, the contractor shall maintain identification as traditional or safety net provider, specialties, enrollees with beginning and ending effective dates, capacity, emergency arrangements or contact, other limitations or restrictions, languages spoken, address, office hours, disability access. See Articles 4.8 and 5. The contractor shall maintain provider history files and provide for easy data retrieval. The system should maintain audit trails of key updates. Providers should be identified with a unique number. The contractor shall be able to cross-reference it provider number with the provider’s EIN or tax number, the provider’s license number, UPIN, Medicaid provider number or Medicaid-assigned number, as provided by the State in response to the contractor’s monthly Provider Network submission, and Medicare provider number where applicable. The contractor shall comply with the HIPAA requirements for provider identification.
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PROVIDER INFORMATION AND PROCESSING REQUIREMENTS. A. Provider Data. The contractor shall maintain individual and group provider network information with basic demographics, EIN or tax identification number, professional credentials, license and/or certification numbers and dates, sites, risk arrangements (i.e., individual and group risk pools), services provided, payment methodology and/or reimbursement schedules, group/individual provider relationships, facility linkages, number of grievances and/or complaints. For PCPs, the contractor shall maintain identification as traditional or safety net provider, specialties, enrollees with beginning and ending effective dates, capacity, emergency arrangements or contact, other limitations or restrictions, languages spoken, address, office hours, disability access. See Article 5. The contractor shall maintain provider history files and provide for easy data retrieval. The system should maintain audit trails of key updates. Providers should be identified with a unique number. The contractor shall be able to cross-reference its provider number with the provider's EIN or tax number, the provider's license number, UPIN, Medicaid provider number, and Medicare provider number where applicable.
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PROVIDER INFORMATION AND PROCESSING REQUIREMENTS 
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Related to PROVIDER INFORMATION AND PROCESSING REQUIREMENTS

  • Safeguarding requirements and procedures (1) The Contractor shall apply the following basic safeguarding requirements and procedures to protect covered contractor information systems. Requirements and procedures for basic safeguarding of covered contractor information systems shall include, at a minimum, the following security controls: (i) Limit information system access to authorized users, processes acting on behalf of authorized users, or devices (including other information systems). (ii) Limit information system access to the types of transactions and functions that authorized users are permitted to execute. (iii) Verify and control/limit connections to and use of external information systems. (iv) Control information posted or processed on publicly accessible information systems. (v) Identify information system users, processes acting on behalf of users, or devices. (vi) Authenticate (or verify) the identities of those users, processes, or devices, as a prerequisite to allowing access to organizational information systems. (vii) Sanitize or destroy information system media containing Federal Contract Information before disposal or release for reuse. (viii) Limit physical access to organizational information systems, equipment, and the respective operating environments to authorized individuals. (ix) Escort visitors and monitor visitor activity; maintain audit logs of physical access; and control and manage physical access devices. (x) Monitor, control, and protect organizational communications (i.e., information transmitted or received by organizational information systems) at the external boundaries and key internal boundaries of the information systems. (xi) Implement subnetworks for publicly accessible system components that are physically or logically separated from internal networks. (xii) Identify, report, and correct information and information system flaws in a timely manner. (xiii) Provide protection from malicious code at appropriate locations within organizational information systems. (xiv) Update malicious code protection mechanisms when new releases are available. (xv) Perform periodic scans of the information system and real-time scans of files from external sources as files are downloaded, opened, or executed.

  • Safeguarding Information Not to use or disclose any information concerning a recipient of services under this contract for any purpose not in conformity with state and federal law except upon written consent of the recipient, or the responsible parent or guardian when authorized by law.

  • Compliance with Safeguarding Customer Information Requirements The Servicer has implemented and will maintain security measures designed to meet the objectives of the Interagency Guidelines Establishing Standards for Safeguarding Customer Information published in final form on February 1, 2001, 66 Fed. Reg. 8616, and the rules promulgated thereunder, as amended from time to time (the “Guidelines”). The Servicer shall promptly provide the Seller information regarding the implementation of such security measures upon the reasonable request of the Seller.

  • IDENTIFYING INFORMATION AND PRIVACY NOTIFICATION (a) FEDERAL EMPLOYER IDENTIFICATION NUMBER and/or FEDERAL SOCIAL SECURITY NUMBER. As a condition to NYSERDA’s obligation to pay any invoices submitted by Contractor pursuant to this Agreement, Contractor shall provide to NYSERDA its Federal employer identification number or Federal social security number, or both such numbers when the Contractor has both such numbers. Where the Contractor does not have such number or numbers, the Contractor must give the reason or reasons why the payee does not have such number or numbers.

  • Electronic and Information Resources Accessibility and Security Standards a. Applicability: The following Electronic and Information Resources (“EIR”) requirements apply to the Contract because the Grantee performs services that include EIR that the System Agency's employees are required or permitted to access or members of the public are required or permitted to access. This Section does not apply to incidental uses of EIR in the performance of the Agreement, unless the Parties agree that the EIR will become property of the State of Texas or will be used by HHSC’s clients or recipients after completion of the Agreement. Nothing in this section is intended to prescribe the use of particular designs or technologies or to prevent the use of alternative technologies, provided they result in substantially equivalent or greater access to and use of a Product.