Common use of Default Assignment of PCP Clause in Contracts

Default Assignment of PCP. If the Member does not request an available PCP within thirty (30) days of Enrollment with the Contractor, then the Contractor must assign the new Member to a network PCP within sixty (60) days of Enrollment, taking into consideration such known factors as current Provider relationships, language needs (to the extent they are known), age and sex, enrollment of family members (e.g., siblings), and area of residence. The Contractor’s policies and procedures must include a documented process for ensuring that the PCP is willing to accept assignment of a Member prior to assigning the Member to the PCP.

Default Assignment of PCP. If the Member does not request an available PCP within thirty (30) days of Enrollment with the Contractor, then the Contractor must assign the new Member to a network PCP within sixty (60) days of Enrollment, taking into consideration such known factors as current Provider relationships, language needs (to the extent they are known), age and sex, enrollment of family members (e.g., siblings), and area of residence. The Contractor’s policies and procedures must include a documented process for ensuring that the PCP is willing to accept assignment of a Member prior to assigning the Member to the PCP.

Default Assignment of PCP. If the Member enrollee does not request an available PCP within thirty (30) days of Enrollment enrollment with the a Contractor, then the Contractor must assign the new Member enrollee to a PCP within its network PCP within sixty (60) days of Enrollmentenrollment, taking into consideration such known factors as current Provider relationshipsprovider relationships (as indicated on the Health Status Survey Questionnaire), language needs (to the extent they are known), age and sex, enrollment of family members (e.g., siblings), and area of residence. The Contractor then must notify the enrollee in writing, on or before the first effective date of enrollment with the Contractor, of his or her PCP’s policies name, location, and procedures must include a documented process for ensuring that the PCP is willing to accept assignment of a Member prior to assigning the Member to the PCPoffice telephone number.

Default Assignment of PCP. If the Member does not request an available PCP within thirty (30) calendar days of Enrollment with the Contractor, then the Contractor must assign the new Member to a network PCP within sixty (60) calendar days of Enrollment, taking into consideration such known factors as current Provider relationships, language needs (to the extent they are known), age and sex, enrollment of family members (e.g., siblings), and area of residence. The Contractor’s policies and procedures must include a documented process for ensuring that the PCP is willing to accept assignment of a Member prior to assigning the Member to the PCP.