Common use of CHANGING YOUR PRIMARY CARE PHYSICIAN Clause in Contracts

CHANGING YOUR PRIMARY CARE PHYSICIAN. If a Member wishes to transfer to a different Primary Care Physician, a request must be submitted in writing or by telephone to Keystone’s Customer Service Department. The change will become effective the first day of the month after the month in which the request is received. A Primary Care Physician may request in writing to the HMO that care for a Member be transferred to another Primary Care Physician. However, a Primary Care Physician shall not seek to have a Member transferred because of the amount of Covered Services required by the Member or because of the physical condition of the Member. Any additional Medically Necessary treatment recommended by the Referred Specialist will require another electronic Referral from a Member’s Primary Care Physician. If the care is part of either the specialty cardiac or gastroenterology care programs designed by the HMO, a single Referral from a Member’s Primary Care Physician will apply for most Inpatient and outpatient services for ninety (90) days from the date of the Referral. Members do not need to return to their Primary Care Physician for Referrals for cardiac or gastroenterology care services by either Referred Specialist during that ninety (90) day period of time.

CHANGING YOUR PRIMARY CARE PHYSICIAN. If a Member wishes to transfer to a different Primary Care Physician, a request must be submitted in writing or by telephone to Keystone’s Customer Service Department. The change will become effective the first day of the month after the month in which the request is received. A Primary Care Physician may request in writing to the HMO that care for a Member be transferred to another Primary Care Physician. However, a Primary Care Physician shall not seek to have a Member transferred because of the amount of Covered Services required by the Member or because of the physical condition of the Member. Any additional Medically Necessary treatment recommended by the Referred Specialist will require another electronic Referral from a Member’s Primary Care Physician. If the care is part of either the specialty cardiac or gastroenterology care programs designed by the HMO, a single Referral from a Member’s Primary Care Physician will apply for most Inpatient and outpatient Outpatient services for ninety (90) days from the date of the Referral. Members do not need to return to their Primary Care Physician for Referrals for cardiac or gastroenterology care services by either Referred Specialist during that ninety (90) day period of time.