Common use of Provider Network Information Clause in Contracts

Provider Network Information. The Contractor shall submit a quarterly Provider Enrollment File report that includes information on all providers of the SNP Plan’s covered health benefits. This includes but is not limited to, PCPs, physician specialists, hospitals and home health agencies. The report shall include contract providers as well as all non-contract providers with whom the Contractor has a relationship. This list need not include retail pharmacies. The Contractor shall submit this report by the 15th of the following months: February, May, August and November. Each quarterly Provider Enrollment File shall include information on all providers of health benefits and shall provide a complete replacement for any previous Provider Enrollment Files submission. Any changes in the provider’s contract status from the previous submission shall be indicated in the file generated in the quarter the change became effective and shall be submitted in the next quarterly file. The provider network information shall be updated regularly as specified by TennCare. Contractor will contact TennCare’s Office of Provider Networks for the proper format for the submission. The Contractor shall develop a network of providers that specifically targets overlap of providers in its network with providers that are also enrolled with one or more TennCare MCOs in order to ensure seamless access to care for FBDE members across the Medicare and Medicaid programs.

Provider Network Information. 1. The Contractor shall submit a quarterly Provider Enrollment File report that includes information on all providers of the SNP Plan’s 's covered health benefits. This includes but is not limited to, PCPs, physician specialists, hospitals hospitals, and home health agencies. The report shall include contract providers as well as all non-contract providers with whom the Contractor has a relationship. This list need not include retail pharmacies. The Contractor shall submit this report by the 15th of the following months: February, May, August and November. Each quarterly Provider Enrollment File shall include information on all providers of health benefits and shall provide a complete replacement for any previous Provider Enrollment Files submission. Any changes in the provider’s 's contract status from the previous submission shall be indicated in the file generated in the quarter the change became effective and shall be submitted in the next quarterly file. The provider network information shall be updated regularly as specified by TennCare. The Contractor will shall contact TennCare’s 's Office of Provider Networks for the proper format for the submission. 2. The Contractor shall develop a network of providers that specifically targets substantial overlap of providers in its network with providers that are also enrolled with one or more its TennCare MCOs MCO in order to ensure seamless access to care for FBDE members across who are seamlessly enrolled in the Medicare and Medicaid programs.Contractor’s D-SNP plan. The Contractor shall report, as part of the Default Enrollment Report specified in Section A.2.i, the number of members seamlessly enrolled in the Contractor’s D-SNP plan that are able to keep the same 1) primary care provider; 2) specialty physicians; and