Common use of Default Assignment of PCP Clause in Contracts

Default Assignment of PCP. If the enrollee does not request an available PCP prior to the twenty-fifth (25th) day of the month prior to the enrollment effective date, then the Contractor may assign the new enrollee to a PCP within its network, taking into consideration such known factors as current provider 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 name, location, and office telephone number.

Appears in 1 contract

Samples: Contract Between the State of Mississippi Division of Medicaid and a Care Coordination Organization (Cco)

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