Standards for private organizations

2020 Edition

Network Administration (NET) 10: Network Application Process

Organizations that deliver services to the network's service population are qualified to provide network services.
2020 Edition

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Purpose

Network services are delivered to a defined population through an integrated network of providers with the goal of ensuring optimal access, quality of care, and consumer satisfaction.
1
The organization's practices fully meet the standard, as indicated by full implementation of the practices outlined in the NET 10 Practice standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the NET 10 Practice standards.
3
Practice requires significant improvement, as noted in the ratings for the NET 10 Practice standards.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the NET 10 Practice standards.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Network application procedures
  • Network application(s)
  • Records of on-site visits and reviews of the specific applications, including the reasons for approving or not approving applications
  • Interviews may include:
    1. Program director
    2. CEO/Commissioner/Executive Management
    3. Provider organizations and independent contractors
    4. Contract Management

 

NET 10.01

The process of becoming a network participant includes:
  1. a written application;
  2. verification of licensure or authorization to provide services; and
  3. an on-site review of compliance with the network’s protocols and requirements.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement.
3
Practice requires significant improvement.
4
Implementation of the standard is minimal or there is no evidence of implementation at all.

 

NET 10.02

The network application process emphasizes the continuity of care for the network's service population by:
  1. establishing continuity of care requirements; and
  2. assessing the impact that an applying provider organization may have on continuity of care for the network’s service population.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement.
3
Practice requires significant improvement.
4
Implementation of the standard is minimal or there is no evidence of implementation at all.

 

NET 10.03

The network management entity's application process includes procedures for:
  1. making decisions to accept or reject applicants;
  2. denying admission to the network;
  3. appealing application decisions; and
  4. terminating the relationship.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement.
3
Practice requires significant improvement.
4
Implementation of the standard is minimal or there is no evidence of implementation at all.