Panel Capacity. Provider shall cooperate to resolve any patient capacity issues, including where Health Plan, Subcontractor, or AHCCCS determine that Provider’s panel size must be adjusted for Provider(s) to meet AHCCCS appointment and clinical performance standards.
Panel Capacity. A. Provider shall specify a capacity of IO IP members he/she is willing to accept under this Agreement.
1. A full time IO IP practitioner means a practitioner available for appointments a minimum of 30 hours per week who sees only IO IP members. If the practitioner is available for appointments less than thirty (30) hours a week and/or sees a combination of IO IP members and other patients, the practitioner’s capacity shall be reduced proportionately. If the practitioner is also a Choice PCP, the practitioner shall not exceed this capacity for both panels combined.
2. If Provider’s Type is Physician, up to a maximum of two thousand five hundred (2,500) members for a full time IO IP physician and a maximum of eight hundred seventy-five (875) members for a full time resident;
3. If Provider’s Type is Group, up to a maximum of two thousand five hundred (2,500) members for each full time IO IP Physician Professional, a maximum of one thousand two hundred fifty (1,250) for each full time Physician Assistant or Certified Nurse Practitioner Professional;
4. If Provider’s type is Physician Assistant or Certified Nurse Practitioner, up to a maximum of one thousand two hundred and fifty (1,250) members for a full time IO IP Physician Assistant or Certified Nurse Practitioner.
B. If Provider initially enrolls as an IO IP PCP, Provider shall specify a capacity of at least 50 members.
C. OHCA does not guarantee Provider an enrollment level nor will OHCA pay for members who are not eligible or excluded from enrollment.
D. Provider may request a change in his/her/its capacity through the EPE system. This request is subject to review according to program standards. In the event Provider requests a lower capacity, OHCA may lower the capacity by disenrolling members to achieve that number or allowing the capacity to adjust as members change their PCP or lose eligibility.
Panel Capacity. A. PROVIDER shall specify a capacity of Choice members he/she is willing to accept under ADDENDUM 1. The maximum capacity is two thousand five hundred (2,500) for a full-time Choice physician. If PROVIDER is a medical resident, his/her enrollment shall not exceed eight hundred seventy-five (875) members. If PROVIDER is also an O-EPIC-IP PCP, PROVIDER shall not exceed these capacities for both panels combined.
B. PROVIDER shall not be a primary supervising physician for more than two mid-level practitioners who are Choice and/or O-EPIC IP PCP’s, whether nurse practitioners or physician assistants. Mid-level practitioners rendering care to PROVIDER’s panel shall be individually contracted with OHCA.
C. OHCA does not guarantee PROVIDER an enrollment level nor will OHCA pay for members who are not eligible or excluded from enrollment.
D. PROVIDER may request a change in his/her capacity by submitting a written request signed by PROVIDER. This request is subject to review according to program standards. In the event PROVIDER requests a lower capacity, OHCA may lower the capacity by disenrolling members to achieve that number or allowing the capacity to adjust as members change their PCP/CM or lose eligibility.
Panel Capacity. A. Provider shall specify a capacity of IO IP members he/she is willing to accept under this Agreement.
B. A full time IO IP practitioner means a practitioner available for appointments a minimum of 30 hours per week who sees only IO IP members. If the practitioner is available for appointments less than thirty (30) hours a week and/or sees a combination of IO IP members and other patients, the practitioner’s capacity shall be reduced proportionately. If the practitioner is also a Choice PCP, the practitioner shall not exceed this capacity for both panels combined.
C. If Provider’s Type is Physician, up to a maximum of two thousand five hundred (2,500) members for a full time IO IP physician and a maximum of eight hundred seventy-five (875) members for a full time resident.
D. If Provider’s Type is Group, up to a maximum of two thousand five hundred (2,500) members for each full time IO IP Physician Professional, a maximum of one thousand two hundred fifty (1,250) for each full time Physician Assistant or Certified Nurse Practitioner Professional.
E. If Provider’s type is Physician Assistant or Certified Nurse Practitioner, up to a maximum of one thousand two hundred and fifty (1,250) members for a full time IO IP Physician Assistant or Certified Nurse Practitioner.
F. If Provider initially enrolls as an IO IP PCP, Provider shall specify a capacity of at least 50 members.
G. OHCA does not guarantee Provider an enrollment level nor will OHCA pay for members who are not eligible or excluded from enrollment.
X. Provider may request a change in his/her/its capacity through the EPE system. This request is subject to review according to program standards. In the event Provider requests a lower capacity, OHCA may lower the capacity by disenrolling members to achieve that number or allowing the capacity to adjust as members change their PCP or lose eligibility.
