Common use of PCP Initiated Changes Clause in Contracts

PCP Initiated Changes. The PCP has the right to have a Member transferred to another Participating PCP. The PCP must submit the request in writing to WHP with at least thirty (30) days advance notice. During that time, the PCP must continue to provide or otherwise arrange for medical care for the Member until the Member has been successfully transferred to another Participating PCP. WHP will work with the PCP and the Member to determine the timing of the transfer. A Member may be transferred to another PCP under the following circumstances as defined by the PCP: (1) The Member’s behavior is disruptive, abusive and/or threatening. (2) The Member does not comply with the PCP’s directions and the PCP believes that a reasonable medical alternative does not exist. (3) A change in the physical condition of the Member requires services that are not within the specialty of the Physician as jointly determined by WHP and the PCP. (4) The Member was previously unable to establish a proper patient-Physician relationship. (5) The Member repeatedly makes but fails to keep appointments for health services.