Written Program Description. MCO has a written utilization management program description, which includes, at a minimum, procedures to evaluate medical necessity, criteria used, information sources and the process used to review and approve the provision of medical services.
Appears in 6 contracts
Sources: Contract for Services (Amerigroup Corp), Amendment 14 to the Agreement for Health Services to the Medicaid Star Program (Centene Corp), Amendment 14 to the Agreement for Health Services to the Medicaid Star Program (Centene Corp)
Written Program Description. MCO has a written utilization management program description, which description that includes, at a minimum, procedures to evaluate medical necessity, criteria used, information sources and the process used to review and approve the provision of medical services.
Appears in 1 contract