Member Consent. 3.9.2.1. CONTRACTOR SHALL obtain verbal or written consent for the use of telehealth as an acceptable mode of delivering services, prior to initial delivery of covered services via telehealth, and must explain the following to members: 3.9.2.1.1. The member has a right to access covered services in person. 3.9.2.1.2. Use of telehealth is voluntary and consent for the use of telehealth can be withdrawn at any time without affecting the member’s ability to access MediCal covered services in the future. 3.9.2.1.3. Non-medical transportation benefits are available for in-person visits. 3.9.2.1.4. Any potential limitations or risks related to receiving covered services through telehealth as compared to an in-person visit, if applicable. 3.9.2.2. CONTRACTOR must also document the member’s verbal or written consent to receive covered services via telehealth prior to the initial delivery of the services. The member’s consent must be documented in their medical record and made available to upon request. A provider may utilize a general consent agreement to meet this documentation requirement if that general consent agreement: 3.9.2.2.1. Specifically mentions the use of telehealth delivery of covered services. 3.9.2.2.2. Includes the information described above. 3.9.2.2.3. Is completed prior to initial delivery of services. 3.9.2.2.4. Is included in the member record.
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Samples: Contract for Services, Contract for Services, Contract for Services