Common use of Primary Care Providers Clause in Contracts

Primary Care Providers. 7.8.1 HMO must have a system for monitoring Member enrollment into its plan to allow HMO to effectively plan for future needs and recruit network providers as necessary to ensure adequate access to primary care and specialty care. The Member enrollment monitoring system must include the length of time required for Members to access care within the network. The monitoring system must also include monitoring after-hours availability and accessibility of PCPs.

Primary Care Providers. 7.8.1 7.9.1 HMO must have a system for monitoring Member enrollment into its plan to allow HMO to effectively plan for future needs and recruit network providers as necessary to ensure adequate access to primary care and specialty care. The Member enrollment monitoring system must include evaluating the length of time required for Members to access care within the network. The monitoring system must also include a means for routinely monitoring after-hours availability and accessibility of PCPs.