Common use of Specialist and Sub-specialist as PCPs Clause in Contracts

Specialist and Sub-specialist as PCPs. The Contractor is permitted to use specialist and sub-specialist physicians as PCPs when such an action is considered by the Contractor to be medically appropriate and cost-effective. As an alternative, the Contractor may restrict it's PCP network to primary care specialties only, while relying on standing referrals to specialists and sub-specialists for Enrollees who require regular visits to such physicians.

Appears in 6 contracts

Samples: Agreement Between (Americhoice Corp), Wellcare Health Plans, Inc., Wellcare Health Plans, Inc.

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Specialist and Sub-specialist as PCPs. The Contractor is permitted to use specialist and sub-specialist physicians as PCPs when such an action is considered by the Contractor to be medically appropriate and cost-effective. As an alternative, the Contractor may restrict it's PCP network to primary care specialties only, while relying on standing referrals to specialists and sub-sub- specialists for Enrollees who require regular visits to such physicians.

Appears in 1 contract

Samples: Wellcare Health Plans, Inc.

Specialist and Sub-specialist as PCPs. The Contractor is permitted to use specialist specialist, and sub-specialist physicians physician as PCPs when such an action is considered by the Contractor to be medically appropriate and cost-effective. As an alternative, the Contractor may restrict it's PCP network to primary care specialties specialist only, while relying on standing referrals to specialists and sub-specialists for Enrollees who require regular visits to such physicians.

Appears in 1 contract

Samples: Amerigroup Corp

Specialist and Sub-specialist as PCPs. The Contractor is permitted to use specialist and sub-specialist physicians as PCPs when such an action is considered by the Contractor to be medically appropriate and cost-effective. As an alternative, the Contractor may restrict it's its PCP network to primary care specialties only, while relying and rely on standing referrals to specialists and sub-specialists for Enrollees who require regular visits to such physicians.

Appears in 1 contract

Samples: Plan Agreement (Amerigroup Corp)

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Specialist and Sub-specialist as PCPs. The Contractor is permitted to use specialist and sub-specialist physicians as PCPs when such an action is considered by the Contractor to be medically appropriate and cost-effective. As an alternative, the Contractor may restrict it's its PCP network to primary care specialties only, while relying and rely on standing referrals to specialists and sub-specialists for Enrollees who require regular visits to such physicians.

Appears in 1 contract

Samples: Model Contract

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