Common use of ADDITIONAL PROVIDER REQUIREMENTS FOR SPECIFIC ACTIVITIES Clause in Contracts

ADDITIONAL PROVIDER REQUIREMENTS FOR SPECIFIC ACTIVITIES. 4.1. Primary Care Provider (PCP) Responsibilities. The PCP must serve as the Covered Person’s initial and most important point of interaction within the Subcontractor or Health Plan network. As such, PCP responsibilities include the following, as further described in the provider manual: (a) Serving as the Covered Person’s Primary Care Provider; (b) Making referrals for specialty care and other Medically Necessary services, both in- and out-of-plan; (c) Coordinating and implementing an individualized care plan for the Covered Person; and (d) Delivering team-based integrated primary and behavioral health Covered Services to Covered Persons and coordinate care with other providers, including the assembly of an interdisciplinary care team, as appropriate.

ADDITIONAL PROVIDER REQUIREMENTS FOR SPECIFIC ACTIVITIES. 4.1. Primary Care Provider (PCP) Responsibilities. The PCP must serve as the Covered Person’s initial and most important point of interaction within the Subcontractor or Health Plan network. As such, PCP responsibilities include the following, as further described in the provider manual: (a) Serving as the Covered Person’s Primary Care Provider; (b) Making referrals for specialty care and other Medically Necessary services, both in- and out-of-plan; (c) Coordinating and implementing an individualized care plan for the Covered Person; and and (d) Delivering team-based integrated primary and behavioral health Covered Services to Covered Persons and coordinate care with other providers, including the assembly of an interdisciplinary care team, as appropriate.

ADDITIONAL PROVIDER REQUIREMENTS FOR SPECIFIC ACTIVITIES. 4.1. Primary Care Provider (PCP) Responsibilities. The PCP must serve as the Covered Person’s initial and most important point of interaction within the Subcontractor or Health Plan network. As such, PCP responsibilities include the following, as further described in the provider manual: (a) Serving as the Covered Person’s Primary Care Provider; (b) Making referrals for specialty care and other Medically Necessary services, both in- and out-of-plan; (c) Coordinating Coordinate and implementing implement an individualized care plan for the Covered Person; and (d) Delivering Deliver team-based integrated primary and behavioral health Covered Services to Covered Persons and coordinate care with other providers, including the assembly of an interdisciplinary care team, as appropriate.