Hhsc uniform managed care manual

Additional information regarding Department of Aging and Disability Services' criteria for clean claims submission is included in HHSC's Uniform Managed Care Manual, which is available on HHSC's website. (4) DADS--The Texas Department of Aging and Disability Services, or its successor agency. determine if Managed Care Organizations (MCOs) complaint intake and resolution processes are consistent with Uniform Managed Care Manual (UMCM) and Uniform Managed Care Contract (UMCC) requirements. The inspection focused on the following objective: • Determine the effectiveness of the MCO’s complaint resolution process. HHSC Uniform Managed Care MANUAL PAGE HHSC UNIFORM MANAGED CARE MANUAL 2 of 4 Uniform Critical Elements Requirements EFFECTIVE DATE April 1, Managed Care Terminology The below terms and definitions must be included in all Member handbooks as a glossary for Members to reference. This requirement is based on 42 C.F.R. § (c)(4).

HHSC Uniform Managed Care MANUAL. CHAPTER PAGE. HHSC UNIFORM MANAGED CARE MANUAL. 2 of 8. Process for Standard Prior Authorization (PA) received with Incomplete or Insufficient Documentation. EFFECTIVE DATE. March. 15, Version I. Applicability. This chapter applies to managed care organizations (MCO) participating in. HHSC Uniform Managed Care MANUAL PAGE HHSC UNIFORM MANAGED CARE MANUAL 4 of 4 Uniform Critical Elements Requirements EFFECTIVE DATE April 1, Primary Care Physician - A physician (M.D. - Medical Doctor or D.O. - Doctor of Osteopathic Medicine) who directly provides or coordinates a range of health-care services for a patient. The HHSC Managed Care Contract includes all documents attached to or incorporated by reference into the contract (such as the HHSC Uniform Managed Care Manual). All Network Provider contracts must be in writing and include the following Standard Contract Provisions.

Items 1 - 10 MCO contracts for the Uniform Managed Care Contract (Bexar, El Paso, as part of the current HHSC Uniform Managed Care Manual change process. 12 de abr. de Human Services Commission (HHSC) Managed care and hospice policy staff over the Texas Medicaid and CHIP Uniform Managed Care Manual at. 1 de mai. de Uniform Managed Care Manual at www.doorway.ru > Services > UnitedHealthcare Community Plan is contracted with HHSC to manage the.