Provider Services Function Sample Clauses

Provider Services Function. The Contractor will operate a Provider Services function during regular business hours. At a minimum, the Contractor's Provider Services staff must be responsible for the following: a) Assisting providers with prior authorization and referral protocols. b) Assisting providers with claims payment procedures. c) Fielding and responding to provider questions and complaints.
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Provider Services Function. (A) The Contractor shall operate Provider Services function during regular business hours. (B) At a minimum, Provider Services staff shall be responsible for the following: (1) training, including ongoing training, of the Contractor’s Providers on Medicaid rules and regulations that shall enable Providers to appropriately render services to Enrollees; (2) assisting Providers to verify whether an individual is enrolled with the Health Plan; (3) assisting Providers with prior authorizations and referral protocols; (4) assisting Providers with claims payment procedures, including training Providers on how to bill using the National Provider Identification Number or the Department- assigned atypical provider identification number that is known to Medicaid to avoid rejection of Encounters; and (5) ▇▇▇▇▇▇▇▇ and responding to Provider questions and the Grievance and Appeals System.
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Provider Services Function. (A) The Contractor shall operate Provider Services function during regular business hours. (B) At a minimum, Provider Services staff shall be responsible for the following: (1) training, including ongoing training, of the Contractor’s Providers on CHIP rules and regulations that shall enable Providers to appropriately render services to Enrollees; (2) assisting Providers to verify whether an individual is enrolled with the Dental Plan; (3) assisting Providers with prior authorizations and referral protocols; (4) assisting Providers with claims payment procedures; and (5) ▇▇▇▇▇▇▇▇ and responding to Provider questions and the Grievance and Appeals System.
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Provider Services Function. The Contractor shall operate Provider Services function during regular business hours.
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Provider Services Function. (A) The Contractor shall operate a Provider services function during regular business hours. (B) At a minimum, Provider services staff shall be responsible for: (1) training, including ongoing training, of the Contractor’s Providers on Medicaid rules and regulations that shall enable Providers to appropriately render services to Enrollees; (2) assisting Providers to verify whether an individual is enrolled with the Contractor; (3) assisting Providers with Service Authorization Requests and referral protocols; (4) assisting Providers with Claims payment procedures, including training Providers on how to bill using the National Provider Identifier (NPI) number or the Department-assigned atypical provider identification number that is known to Medicaid to avoid rejection of Encounter Data; and
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Related to Provider Services Function

  • MANAGEMENT FUNCTIONS B.1 The Association recognizes that the management of the Hospital and the direction of working forces are fixed exclusively in the Hospital and shall remain solely with the Hospital except as specifically limited by the provisions of this Agreement and, without restricting the generality of the foregoing, the Association acknowledges that it is the exclusive function of the Hospital to: (a) maintain order, discipline and efficiency; (b) hire, assign, retire, discharge, direct, promote, demote, classify, transfer, lay- off, recall, and suspend or otherwise discipline nurses, provided that a claim of discharge or discipline without just cause may be the subject of a grievance and dealt with as hereinafter provided; (c) determine, in the interest of efficient operation and high standards of service, job rating and classification, the hours of work, work assignments, methods of doing the work, and the working establishment for the service; (d) generally to manage the operation that the Hospital is engaged in and, without restricting the generality of the foregoing, to determine the number of personnel required, methods, procedures, and equipment in connection therewith; (e) make, enforce, and alter from time to time reasonable rules and regulations to be observed by the nurses which are not inconsistent with the provisions of this Agreement. B.2 These rights shall not be exercised in a manner inconsistent with the provisions of this Agreement.