Pending Members. If a pending member (an eligible individual subsequent to MCOP selection or assignment to an MCOP, but prior to his or her membership effective date) contacts the selected MCOP, the MCOP shall provide any membership information requested, including but not limited to explaining how to access services as an MCOP member and assistance in determining whether current services require prior authorization. The MCOP shall also ensure any care coordination (e.g., PCP selection, prescheduled services, and transition of services) information provided by the pending member is logged in the MCOP’s system and forwarded to the appropriate MCOP staff for processing as required.
Appears in 16 contracts
Samples: Provider Agreement, Provider Agreement, Provider Agreement
