Provider Responsibilities

Provider Roles and Responsibilities

Provider Roles and Responsibilities, Mass Advantage Provider Agreement, Safeguarding and Maintenance of Medical Records, Network Participation, Notification Requirements, Qualifications and Requirements for Provider Participation, Primary Care (PCP) Responsibilities, Specialist Responsibilities, Responsibilities of all Mass Advantage Providers.

Credentialing and Recredentialing

Provider Enrollment, Credentialing and Recredentialing Criteria, and Changing Provider or Practice information.

Medical Records Requests and Submission of Encounter Data

Confidentiality and General Consent, Encounter Data Submission, Encounter Data for Risk Adjustment purposes, Risk Adjustment Data Validation (RADV) Audits conducted by CMS.