Primary Care Network List Sample Clauses

Primary Care Network List. (1) The MCO must supply all Local Agencies within its Service Area with copies of a standardized document (known as a Primary Care Network List, or PCNL) that provides information about the MCO’s Medicare and Medicaid Provider network and that includes a description of the essential components of the MCO, to be used by the Local Agencies to educate consumers. This document must follow the STATE specification as indicated in the STATE document “PCNL Guidelines,” and must be Prior Approved by the STATE in accordance with section 3.2.4(B). The document must be printed on a grade of paper that is equivalent to bond paper that is not less than nineteen (19) pound bond but not greater than twenty (20) pound bond. If the PCNL has a cover, the grade of paper may be on un-coated offset paper or on glossy paper. The paper must be 8 ½" x 11" or 17" x 11". A 17" x 11" document must fold to 8 ½" x 11". The document must contain the following information: (a) A list of contracted Providers with summary information, which shall include but is not limited to addresses and phone numbers including clinics, Primary Care physicians, specialists, hospitals, Nursing Facilities, and Care Systems The MCO may satisfy or partially satisfy the requirement to list specialists by listing multi-specialty clinics. The PCNL must indicate Providers who speak a non-English language and identify Providers that are not accepting new patients within the Service Area at the time the list is prepared. The MCO must also provide information upon request regarding a specific Provider, including specialists, if the Provider is not listed in the PCNL. The MCO may list other affiliated Providers and their addresses or provide a toll-free phone number where a Potential Enrollee may call to obtain the specific information. The information required by this section may also be listed on the MCO’s web site. (b) A toll-free telephone number that the Recipient may contact regarding MCO coverage or procedures, and updated information regarding Providers, language spoken, and open and closed panels of Providers. (c) Information that oral interpretation is available for any language and written information will be available in prevalent non-English languages. (d) Information about how to access mental health, chemical dependency, Elderly Waiver, Home Care, dental, and Medical Emergency and Urgent Care services. (e) A description of the MCO’s MSC+ and MSHO Care Systems, Care Coordination systems, Case Managemen...

Primary Care Network List. When the HEALTH PLAN is new to a Service Area, the HEALTH PLAN must supply the Local Agency, and the STATE for MinnesotaCare, with a supply of the final, printed and approved Primary Care Network List 10 calendar days in advance of the Education Begin Date and on or before the first day of each calendar quarter thereafter, in quantities sufficient to meet the Local Agency or STATE need for a calendar quarter. If the HEALTH PLAN’s Service Area expands for MinnesotaCare, additional Primary Care Network Lists must be supplied to the STATE 60 days prior to the effective date of the expanded Service Area. The HEALTH PLAN must update the Primary Care Network List as necessary to maintain accuracy, particularly with regard to the list of Participating Providers. The Primary Care Network List and all revisions to the Primary Care Network List must be approved in writing by the STATE before copies are provided to the Local Agency. Such approval by the STATE shall not be unreasonably withheld.

Primary Care Network List. (PCNL).‌