COA’s Network Administration standards apply to network management entities (NME) and address core administrative practices that contribute to the effective management and coordination of an integrated network of service providers.
There are many types of networks and any number of ways that a network can be organized. It could be said that every service-provider network is unique. This is due to many factors that can include: the needs and demographics of the population being served; the availability--both geographically and numerically--of qualified providers and provider organizations; whether the network was formed in response to a legislative or regulatory mandate or was formed voluntarily; its mission and mandates; whether it was formed to realize administrative efficiencies, create a system of care, or compete for managed care contracts; and others.
In all cases, high-functioning service networks provide individuals and families with services that are appropriate to their needs and are provided in a timely manner by qualified providers.
Interpretation: Networks generally are in business to ensure and manage the quality of services provided to covered persons and families.
Note: Core administrative practices related to the administration and management of networks are not limited to the Network Administration standards, but are also reflected in each of the 8th Edition's Administration and Management and Service Delivery Administration standards sections.
NA The agency is not a network management entity.
Note: Please see COA's Network Policies and Procedures_Manual in the Tools Index for additional assistance with this standard.