Second Opinions. 4.11.7.1 The Contractor shall provide for a second opinion in any situation when there is a question concerning a diagnosis or the options for surgery or other treatment of a health Condition when requested by any Member of the Health Care team, a Member, parent(s) and/or guardian (s), or a social worker exercising a custodial responsibility. 4.11.7.2 The second opinion must be provided by a qualified Health Care Professional within the network, or the Contractor shall arrange for the Member to obtain one outside the Provider network. 4.11.7.3 The second opinion shall be provided at no cost to the Member.
Appears in 6 contracts
Samples: Contract for Provision of Services, Contract for Provision of Services (Wellcare Health Plans, Inc.), Contract for Provision of Services (Wellcare Health Plans, Inc.)
Second Opinions. 4.11.7.1 4.11.6.1 The Contractor shall provide for a second opinion in any situation when there is a question concerning a diagnosis or the options for surgery or other treatment of a health Condition when requested by any Member of the Health Care team, a Member, parent(s) and/or guardian (s), or a social worker exercising a custodial responsibility.
4.11.7.2 4.11.6.2 The second opinion must be provided by a qualified Health Care Professional within the network, or the Contractor shall arrange for the Member to obtain one outside the Provider network.
4.11.7.3 4.11.6.3 The second opinion shall be provided at no cost to the Member.
Appears in 5 contracts
Samples: Contract for Provision of Services (Amerigroup Corp), Contract for Provision of Services (Centene Corp), Contract (Wellcare Health Plans, Inc.)
Second Opinions. 4.11.7.1 10.1.14.1 The Contractor shall provide for a second opinion in any situation when there is a question concerning a diagnosis or the options for surgery or other treatment of a health Condition condition when requested by any Member member of the Health Care health care team, a Memberan Enrollee, parent(s) and/or guardian (sguardian(s), or a social worker exercising custodial responsibility the right to request a custodial responsibilitysecond opinion.
4.11.7.2 The second opinion must be provided by a qualified Health Care Professional within the network, or the Contractor shall arrange for the Member to obtain one outside the Provider network.
4.11.7.3 The second opinion shall be provided at no cost to the Member.
Appears in 1 contract
Samples: Core Contract (Amerigroup Corp)
