Common use of Specialists as PCPs Clause in Contracts

Specialists as PCPs. Contractor shall offer pregnant Enrollees and Enrollees with Chronic Health Conditions, disabilities, or special health care needs the option of choosing a specialist to be their PCP or Medical Home. Such Enrollees or their Providers may request a specialist as a PCP at any time. Contractor shall contact the Enrollee promptly after the request to schedule an assessment. Contractor’s Medical Director will approve or deny requests after determining that the Enrollee meets criteria and whether the specialist is willing to fulfill the role and all the obligations of PCP or Medical Home.

Appears in 3 contracts

Samples: Contract for Health Services, Contract for Health Services, Contract for Health Services

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Specialists as PCPs. Contractor shall offer pregnant Enrollees and Enrollees with Chronic Health Conditions, disabilities, or special health care healthcare needs the option of choosing a specialist to be their PCP or Medical HomePCP. Such Enrollees or their Providers may request a specialist as a PCP at any time. Contractor shall contact the Enrollee promptly after the request to schedule an assessment. Contractor’s Medical Director medical director will approve or deny requests after determining that whether the Enrollee meets criteria and whether the specialist is willing to fulfill the role and all the obligations of PCP or Medical Home.a PCP.‌

Appears in 3 contracts

Samples: Contract for Furnishing Health Services by a Managed Care Organization, State of Illinois Contract, Contract for Furnishing Health Services by a Managed Care Organization

Specialists as PCPs. The Contractor shall offer pregnant Enrollees and Enrollees with Chronic Health Conditions, disabilities, or special health care needs the option of choosing a specialist to be their PCP or Medical Homemedical home. Such Enrollees or their Providers may request a specialist as a PCP at any time. The Contractor shall contact the Enrollee promptly after the request to schedule an assessmentdetermine whether the Enrollee needs a specialist as a PCP. The Contractor’s Medical Director will approve or deny requests after determining that whether the Enrollee meets criteria and whether the specialist is willing to fulfill the role and all the obligations of PCP or Medical Homemedical home.

Appears in 3 contracts

Samples: Contract, Contract, Contract

Specialists as PCPs. The Contractor shall offer pregnant Enrollees and Enrollees with Chronic Health Conditions, disabilities, or special health care needs the option of choosing a specialist to be their PCP or Medical Home. Such Enrollees or their Providers may request a specialist as a PCP at any time. The Contractor shall contact the Enrollee promptly after the request to schedule an assessmentdetermine whether the Enrollee needs a specialist as a PCP. The Contractor’s Medical Director will approve or deny requests after determining that whether the Enrollee meets criteria and whether the specialist is willing to fulfill the role and all the obligations of PCP or Medical Home.

Appears in 3 contracts

Samples: Contract, Contract, Contract

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Specialists as PCPs. Contractor shall offer pregnant Enrollees and Enrollees with Chronic Health Conditions, disabilities, or special health care needs the option of choosing a specialist to be their PCP or Medical HomePCP. Such Enrollees or their Providers may request a specialist as a PCP at any time. Contractor shall contact the Enrollee promptly after the request to schedule an assessment. Contractor’s Medical Director will approve or deny requests after determining that the Enrollee meets criteria and whether the specialist is willing to fulfill the role and all the obligations of PCP or Medical HomePCP.

Appears in 2 contracts

Samples: Contract for Health Services, Contract for Health Services

Specialists as PCPs. Contractor shall offer pregnant Enrollees and Enrollees with Chronic Health Conditions, disabilities, or special health care healthcare needs the option of choosing a specialist to be their PCP or Medical HomePCP. Such Enrollees or their Providers may request a specialist as a PCP at any time. Contractor shall contact the Enrollee promptly after the request to schedule an assessment. Contractor’s Medical Director medical director will approve or deny requests after determining that whether the Enrollee meets criteria and whether the specialist is willing to fulfill the role and all the obligations of PCP or Medical Homea PCP.

Appears in 2 contracts

Samples: State of Illinois Contract, State of Illinois Contract

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