Standing Referral to a Specialty Care Center Sample Clauses

Standing Referral to a Specialty Care Center. If you have a life-threatening condition or disease or a degenerative and disabling condition or disease you may request a standing referral to a specialty care center that is a Participating Provider. We will consult with your PCP, your specialist and the specialty care center to decide whether such a referral is appropriate.
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Standing Referral to a Specialty Care Center. If you have a life-threatening or a degenerative and disabling condition or disease, either of which requires specialized medical care over a prolonged period of time, you may receive a standing referral to a network specialty care center with expertise in treating the life-threatening or degenerative and disabling disease or condition. If we, or your PCP or specialist in consultation with our Medical Director, determine that your care would most appropriately be provided by a specialty care center, we will refer you to such center. Any such referral shall be pursuant to a treatment plan developed by the specialty care center and approved by us, in consultation with your PCP and specialist, when applicable. For purposes of this provision, a specialty care center is one that is accredited or designated by an agency of the state or federal government or by a voluntary national health organization as having special expertise in treating your life-threatening or disabling condition or disease.
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Related to Standing Referral to a Specialty Care Center

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