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COMMUNITY HEALTHCHOICES (CHC) OPERATIONS MEMORANDUM #201905 ___ SUBJECT: Circumstances When Co-managed Care Organizations (MCO) Must Transmit the Home and CommunityBased Services (HUBS) Eligibility/Ineligibility/Change

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How to fill out community healthchoices agreement table

01

Review the agreement table template provided by Community HealthChoices.

02

Fill in all required information in the designated columns of the table.

03

Ensure that all information provided is accurate and up-to-date.

04

Submit the completed agreement table to the appropriate Community HealthChoices contact for review and approval.

Who needs community healthchoices agreement table?

01

Healthcare providers participating in the Community HealthChoices program.

02

Organizations or agencies involved in delivering care to Community HealthChoices members.

03

Any entity required to comply with Community HealthChoices regulations and reporting requirements.

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What is community healthchoices agreement table?

The community healthchoices agreement table is a document outlining the terms and conditions of the agreement between a healthcare provider and Community HealthChoices program.

Who is required to file community healthchoices agreement table?

Healthcare providers participating in the Community HealthChoices program are required to file the agreement table.

How to fill out community healthchoices agreement table?

The table can be filled out online on the Community HealthChoices program website by entering the required information.

What is the purpose of community healthchoices agreement table?

The purpose of the table is to establish the agreement terms between the healthcare provider and the Community HealthChoices program.

What information must be reported on community healthchoices agreement table?

The table must include details on services provided, reimbursement rates, quality standards, and compliance requirements.

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