Self-Referral. The member may recognize the need for assistance and seek assistance through the program.
Self-Referral. The member may recognize the need for assistance through the program.
Self-Referral. Direct Access The PH-MCO may not require referrals from a PCP for certain services. A Member may self-refer for vision, dental care, obstetrical and gynecological (OB/GYN) services, providing the Member obtains the services within the Provider Network. A Member may access chiropractic services in accordance with the process set forth in MA Bulletin 99-10-12, and physical therapy services in accordance with the amended Physical Therapy Act (63 P.S. §§1301 et seq.) The PH-MCO may not use either the referral process or Prior Authorization to manage the utilization of Family Planning Services. The PH-MCO may not restrict the right of a Member to choose a Health Care Provider for Family Planning Services and must make such services available without regard to marital status, age, sex or parenthood. Members may access at a minimum, health education and counseling necessary to make an informed choice about contraceptive methods, pregnancy testing and counseling, breast cancer screening services, basic contraceptive supplies such as oral birth control pills, diaphragms, foams, creams, jellies, condoms (male and female), Norplant, injectables, intrauterine devices, and other family planning procedures as described in Exhibit F, Family Planning Services Procedures. The PH-MCO must pay for Out-of- Network Services. The PH-MCO must provide Members with direct access to OB/GYN services and must have a system in place that does not erect barriers to care for pregnant women and does not involve a time-consuming authorization process or unnecessary travel. The PH-MCO must permit Members to select a Network Provider, including nurse midwives, to obtain maternity and gynecological care without prior approval from a PCP. This includes selecting a Network Provider to provide an annual well-woman gynecological visit, primary and preventive gynecology care, including a PAP smear and referrals for diagnostic testing related to maternity and gynecological care, and Medically Necessary follow-up care. In situations where a new Member is pregnant and already receiving care from an Out-of-Network OB-GYN specialist at the time of Enrollment, the Member may continue to receive services from that specialist throughout the pregnancy and postpartum care related to the delivery, pursuant to 28 Pa. Code §9.684.
Self-Referral. When a student recognizes that he/she has a problem with chemical use, and chooses to report to school personnel that she/he wants to do something about this problem, the school will cooperate as fully as possible with this student, and he/she will receive assistance.
Self-Referral. Section 1. An employee who voluntarily identifies himself or herself as someone who uses illegal drugs or misuses alcohol, prior to being identified through other means, shall not be identified to the Agency on the first occurrence of such self-referral, for the purposes of taking disciplinary action.
Section 2. An employee may self-refer except under the following circumstances:
a. the employee has received specific notice that he/she is to be tested for drugs or alcohol;
b. a substance abuse staff has arrived at the employee’s facility to conduct testing;
c. the Agency is awaiting the results of a drug test taken by the employee; or
d. the employee has previously completed an Agency-approved rehabilitation program in accordance with DOT Order 3910.1C.
Section 3. An employee who voluntarily self-refers under this Article shall not be subject to disciplinary action based only on substance abuse, if the employee:
a. obtains counseling through the Agency’s Employee Assistance Program, and completes EAP recommended rehabilitation; and
b. refrains from any further use of illegal drugs or alcohol misuse in accordance with the policy of DOT Order 3910.1C.
Section 4. The flight surgeon shall contact the employee’s facility manager and notify him/her of the approximate length of time that the employee will be temporarily removed from their safety sensitive duties for medical reasons.The nature of the medical problem shall not be released.
Section 5. An employee who uses sick leave in connection with rehabilitation under this Article shall not be required to provide a medical certificate under Article 25.
Section 6. When the employee has sufficiently recovered, he/she will be scheduled for return to duty substance testing. Upon passing the return to duty test, the employee’s facility manager shall be informed that the employee is no longer removed for medical reasons, and may return to their normal duties. If the employee does not pass the return to duty test, the employee’s manager will be informed and the employee offered an opportunity to enter into a last chance agreement.
Section 7. All follow-up testing shall be conducted in a manner that will protect the privacy of the employee and whenever feasible, be conducted off the facility grounds.
Section 8. If the employee adheres to his/her rehabilitation/treatment plan, and all the employee’s follow-up test results are negative for a period of one
(1) year, the employee will have successfully completed the rehabil...
Self-Referral. There are some services which can be accessed without a referral from the Member’s Primary Care Physician (PCP). Vision, dental care, obstetrical and gynecological (OB/GYN) services may be self-referred, provided the Member obtains the services from the PH-MCO’s Provider Network.
Self-Referral. Direct Access
Self-Referral. A. If an employee believes they have a substance abuse problem, the employee may make a confidential appointment with a counselor at EAP.
B. The counselor will evaluate the case and determine the appropriate level and type of treatment, if any. The EAP will approve a plan and facility. These decisions will be made jointly with the individual seeking treatment.
C. The counselor will notify the City by an employee code number that treatment and funding is authorized. Claims administration will be handled confidentially as are other health insurance claims.
Self-Referral. An employee who voluntarily identifies himself/herself as someone who uses illegal drugs or misuses alcohol, prior to being identified through other means, will not be identified to the Employer on the first occurrence of such self-referral, for the purposes of taking disciplinary action.
Self-Referral. A Member who makes a self-referral (e.g., no management involvement or positive results) will be allowed to take accumulated sick leave, vacation leave, E.O.D. compensatory time, and Family Medical Leave Act leave to participate in a treatment program. The cost of any treatment or rehabilitation services will be paid for by the Member or the Member’s insurance provider.
