Common use of In-Network Self-Referrals Clause in Contracts

In-Network Self-Referrals. The Contractor agrees to have written policies and procedures that permit members to self-refer for in-network substance use disorder services, rather than obtaining a referral from their Primary Care Provider. These policies and procedures must identify timely access standards for substance use disorder services. The Contractor will notify members of the right to access substance use disorder services without a referral from their PCP. The Contractor will establish provisions for coordination of this care with the PCP that takes into account patient confidentiality requirements.

In-Network Self-Referrals. The Contractor agrees to have written policies and procedures that permit members to self-refer for in-network substance use disorder abuse services, rather than obtaining a referral from their Primary Care Provider. These policies and procedures must identify timely access standards for substance use disorder services. The Contractor will notify members of the right to access substance use disorder services without a referral from their PCP. The Contractor will shall establish provisions for coordination of this care with the PCP that takes into account patient confidentiality requirements.