PROVIDER MANUAL - Sendero Health Plans
PROVIDER MANUAL - Sendero Health Plans
PROVIDER MANUAL - Sendero Health Plans
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<strong>Sendero</strong> Provider Manual Page 29 of 184<br />
Permitted Activities<br />
stickers by ALL contracted MCOs. These stickers<br />
can not indicate anything more than that the<br />
“health plan is accepted or welcome”. Stickers<br />
MUST display the applicable STAR and/or CHIP<br />
logo.<br />
plan over another.<br />
Prohibited Activities<br />
6. Providers may distribute application booklets to<br />
families of uninsured children and may help with<br />
completing the application.<br />
7. Providers may direct patients to enroll in<br />
STAR or CHIP programs by calling the state<br />
Administrative Service Contractor.<br />
DEFINITION: <strong>Health</strong> Education Materials are materials produced by the health plan or a third party that<br />
contains information related to health (i.e. immunization, diabetes, heart disease, birth control, prenatal care,<br />
Texas <strong>Health</strong> Steps screenings, nutrition, health education classes, etc.) and DOES NOT include<br />
announcements of health fairs, materials that are specific to a given health plan, or materials that are specific to<br />
STAR/Medicaid or CHIP programs.<br />
3.14 Medical Records<br />
Maintenance of Records<br />
All <strong>Sendero</strong> providers are required to maintain a written or electronic medical record that complies with the<br />
standards of the health care industry and with the requirements of applicable federal, state and local laws, rules<br />
and regulations. Records must be:<br />
Individual to each patient<br />
A complete and accurate representation of all medical services, counseling and patient education<br />
provided by the provider including ancillary services<br />
Maintained in an orderly and legible fashion<br />
Kept secured to ensure the maintenance of confidentiality and be accessible only to practice employees<br />
and eligible persons as permitted by law<br />
Maintained pursuant to procedures of confidentiality that comply with the <strong>Health</strong> Insurance Portability<br />
and Accountability Act (HIPAA)<br />
Made available to the patient according to the written policies and procedures<br />
Made available to appropriate parties allowed to view such records pursuant to HIPAA and other<br />
relative federal, state and local laws, rules and regulations<br />
Electronic Medical Records<br />
Providers, who use electronic medical recording keeping within their office, must have a system that conforms<br />
to all the requirements of the <strong>Health</strong> Insurance Portability and Accountability Act (HIPAA) and the <strong>Health</strong><br />
<strong>Sendero</strong> Customer Services 1-855-526-7388 Network Management 1-855-895-0475<br />
<strong>Health</strong> Services Dept.: 1-855-297-9191 (FAX 1-512-275-2862)