Continuing Care with Terminated Providers. A. When a Preferred Provider terminates their agreement with CareFirst, for any reason except for cause, benefits will be provided for continuing care rendered by the terminated provider as described in this section. CareFirst will send a notice to the Member that the Preferred Provider is no longer available. B. The Member may, upon request, continue to receive Covered Services from his/her provider for up to 90 days after the date of the notice of the provider termination from CareFirst provider panel, if termination was for reasons unrelated to fraud, patient abuse, incompetence, or loss of licensure status. In addition, a Member may continue treatment with a terminated provider if: 1. A Member was in an active course of treatment with the terminated provider prior to the date the Member was notified. The Member needs to request, from CareFirst, to continue receiving care from the terminated provider. Benefits will be provided for a period of 90 days from the date the Member is notified by CareFirst that the terminated provider is no longer available.
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Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan
