Managed Care Organization Provider Access Agreement - Utah

Managed Care Organization Provider Access Agreement is a legal document that was released by the Utah Department of Health and Human Services - a government authority operating within Utah.

FAQ

Q: What is a Managed Care Organization (MCO)?A: A Managed Care Organization (MCO) is a healthcare provider that coordinates and manages the healthcare services for a group of people.

Q: What is a Provider Access Agreement?A: A Provider Access Agreement is a legal contract between a healthcare provider and a Managed Care Organization (MCO) that outlines the terms and conditions for the provider's participation in the MCO's network.

Q: Why is a Provider Access Agreement important?A: A Provider Access Agreement is important as it sets forth the rights, obligations, and expectations of both the healthcare provider and the Managed Care Organization (MCO) in their working relationship.

Q: What does a Provider Access Agreement typically include?A: A Provider Access Agreement typically includes details about reimbursement rates, service requirements, quality standards, confidentiality, termination clauses, and dispute resolution procedures.

Q: How can a healthcare provider join a Managed Care Organization's (MCO) network?A: To join a Managed Care Organization (MCO)'s network, a healthcare provider typically needs to sign a Provider Access Agreement and meet the MCO's eligibility criteria.

Q: Are healthcare providers required to participate in a Managed Care Organization's (MCO) network?A: Participation in a Managed Care Organization (MCO) network is typically voluntary for healthcare providers, although some providers may choose to join to increase their patient base and access to insurance reimbursements.