Medicare Managed Care Manual (Pub. 100-16), Ch. 4 § 110.2.3

Provider Directory Dissemination and Timing

Last amended: 2016Year: 2016Length: 290 wordsOfficial source
110.2.3 – Provider Directory Dissemination and Timing (Rev. 121, Issued: 04-22-16, Effective: 04-22-16, Implementation: 04-22-16) MAOs must make the provider directory available to all enrollees at the time of enrollment, and at least annually thereafter by September 30. MAOs have some flexibility in how they provide access to their provider directories. MAOs must send all enrollees either the provider directory in hard copy, or a distinct and separate notice (in hard copy) describing where enrollees can find the provider directories online and how enrollees can request a hard copy. This notice must be a stand-alone document (i.e., not bound with other materials) and may be included in the same mailing envelope as the Annual Notice of Change/Evidence of Coverage (ANOC/EOC). To take advantage of this flexibility under §422.11 to provide a notice of on-line availability instead of providing a hard copy, an MAO must incudes in the notice the following to ensure that enrollees may access a hard copy: • If the MAO will not allow requests for a hard copy by email: “If you need help finding a network provider, please call [customer service phone #] or visit [URL] to access our online [searchable, if applicable] directory. If you would like a provider directory mailed to you, you may call the number above, or request one at the website link provided above.”; • If the MAO will allow requests for a hard copy by email: “If you need help finding a network provider, please call [customer service phone #] or visit [URL] to access our online [searchable, if applicable] directory. If you would like a provider directory mailed to you, you may call the number above, request one at the website link provided above, or email [MAO email address].”
Medicare Managed Care Manual (Pub. 100-16), Ch. 4 § 110.2.3: Provider Directory Dissemination and Timing | Justis AI