Common use of Coordinating Access for Emergency Conditions and Urgent Care Services Clause in Contracts

Coordinating Access for Emergency Conditions and Urgent Care Services. The Contractor must ensure linkages among the PCP, the PCT, and any appropriate acute, long term care, or behavioral health Providers to keep all parties informed about utilization of services for Emergency Conditions and Urgent Care. The Contractor may not require advance approval for the following services: a. Any services for Emergency Conditions; b. Emergency behavioral health care; c. Urgent Care sought out of the Service Area; d. Urgent Care under unusual and extraordinary circumstances provided in the Service Area when the contracted medical Provider is unavailable or inaccessible; e. Direct-access women’s services; and f. Out-of-area renal dialysis services.