Standards for Credentialing and Recredentialing Sample Clauses

Standards for Credentialing and Recredentialing. HCA intends to implement centralized credentialing and recredentialing applicable to all MCOs during the term of this Agreement. The CONTRACTOR shall assist HCA with the transition and implementation of centralized credentialing and recredentialing and comply with all HCA requirements related thereto. Pending the implementation of centralized credentialing and recredentialing by HCA, the CONTRACTOR shall establish and implement a documented process for credentialing and recredentialing its Contract Providers, or Providers it employs, to treat Members. The CONTRACTOR’s credentialing and recredentialing process shall adhere to NMAC 13.10.28.10 and NCQA credentialing and recredentialing standards and include, but not be limited to, (i) defining the scope of Providers covered; (ii) the criteria and the primary source verification of information used to meet the criteria; (iii) use of a single, centralized, NCQA approved CVV to process applications and perform primary source verifications; (iv) the process and time frames for making credentialing and recredentialing decisions; (v) the time frame for loading approved providers to the CONTRACTOR’s claims payment system; and (vi) the extent of delegating credentialing and recredentialing arrangements. The CONTRACTOR’s credentialing and recredentialing process shall not discriminate against providers, including those that serve high-risk populations or specialize in conditions that require costly treatment. The CONTRACTOR shall work with all other MCOs to contract with a single, centralized and NCQA approved CVV to process credentialing applications and perform primary source verifications. The CVV’s responsibilities shall include the following: Receiving and processing completed applications, attestations, and primary source verification documents for current and prospective Contract Providers; Offering a portal that allows providers to submit applications and upload all required documentation for the credentialing and recredentialing process online; Performing credentialing verification processes on behalf of the CONTRACTOR for initial credentialing, and for recredentialing every three (3) years; and Reporting credentialing and recredentialing metrics on a monthly basis to the CONTRACTOR, to include the volume of credentialing applications and recredentialing activities; time frame for processing applications; credentialing and recredentialing outcomes; and any other metrics required by HCA. Prior to executing a ...
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Standards for Credentialing and Recredentialing. The CONTRACTOR shall document the mechanism for credentialing and recredentialing of Contract Providers or providers it employs to treat Members outside of the inpatient setting and who fall under its scope of authority and action. This documentation shall include, but not be limited to, defining the scope of providers covered, the criteria and the primary source verification of information used to meet the criteria, the process used to make decisions that shall not be discriminatory and the extent of delegated credentialing and recredentialing arrangements. The CONTRACTOR shall:
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Related to Standards for Credentialing and Recredentialing

  • Credentialing Firm shall be required to access Citizens’ online vendor credentialing system (“CAIS”) to input, update and maintain certain information about Firm and the persons who will perform work related to this Agreement (“Staff”), as provided below and in Exhibit B attached hereto.

  • Credentialing Requirements Registry Operator, through the facilitation of the CZDA Provider, will request each user to provide it with information sufficient to correctly identify and locate the user. Such user information will include, without limitation, company name, contact name, address, telephone number, facsimile number, email address and IP address.

  • Monitoring and Review The Provider agrees to allow access to the Department for purposes of monitoring and review. This access includes but is not limited to client records, fiscal records, staffing records, policy and procedural manuals, facilities, staff, and children in care of the Department. The Department will conduct quality reviews, which may include site-based quality review visits.

  • Monitoring and Compliance Every year during the term of this Agreement on the anniversary date of the effective date of the Agreement, the Restaurant shall provide to the United States a narrative report of the actions taken during the reporting period to remove any barriers to access and otherwise enhance accessibility for individuals with disabilities at the Restaurant and any plans for action concerning ADA compliance in the coming year. The report shall include as an exhibit copies of any complaint, whether formal or informal, received during the reporting period alleging that the Restaurant was not being operated in compliance with the ADA or otherwise discriminated against any person on account of disability. The Owner and Operator of the Restaurant shall cooperate in good faith with any and all reasonable requests by the United States for access to the Restaurant and for information and documents concerning the Restaurant's compliance with this Agreement and the ADA. The United States shall have the right to verify compliance with this Agreement and the ADA, both as set forth in this Agreement and through any means available to the general public, including visits to the public areas of the Restaurant and communications with Restaurant staff. The United States shall have the right to inspect the facility at any time, and counsel for the United States need not identify themselves in the course of visits to the public areas.

  • Evaluation, Testing, and Monitoring 1. The System Agency may review, test, evaluate and monitor Grantee’s Products and services, as well as associated documentation and technical support for compliance with the Accessibility Standards. Review, testing, evaluation and monitoring may be conducted before and after the award of a contract. Testing and monitoring may include user acceptance testing. Neither the review, testing (including acceptance testing), evaluation or monitoring of any Product or service, nor the absence of review, testing, evaluation or monitoring, will result in a waiver of the State’s right to contest the Grantee’s assertion of compliance with the Accessibility Standards. 2. Grantee agrees to cooperate fully and provide the System Agency and its representatives timely access to Products, records, and other items and information needed to conduct such review, evaluation, testing, and monitoring.