Common use of Standing Referrals Clause in Contracts

Standing Referrals. A Member’s PCP may issue a standing Referral when special conditions require ongoing care. A special condition is a condition or disease that is life-threatening, degenerative, or disabling and requires specialized medical care over a prolonged period of time. A standing Referral must be made in accordance to a treatment plan and Prior Approved in writing by our Medical Management team.

Appears in 3 contracts

Sources: Member Benefit Agreement, Member Benefit Agreement, Member Benefit Agreement