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1367.27. (a) Commencing July 1, 2016, a health care service plan shall publish and maintain a provider directory or directories with information on contracting providers that deliver health care services to the plan’s enrollees, including those that accept new patients. A provider directory shall not list or include information on a provider ...
18 maj 2021 · 1. What are the basic requirements to be licensed as a primary care clinic (PCC)? A primary care clinic must be a tax-exempt, nonprofit corporation. Pursuant to Health and Safety Code (HSC) § 1204, subsection (a)(1)(A), in a community clinic, any charges to the patient shall be based on the patient’s ability to pay, utilizing a sliding fee scale.
Track and document appointments, clinical findings, treatment plans and care received by members referred to specialists or other health care providers to ensure continuity of care. Screen and evaluate procedures for detection and treatment of or referral for any known or suspected behavioral health problems and disorders.
In most health plans, your primary care doctor manages your care. This means that you need a referral from your primary care doctor for most other medical services. You may also need prior approval for the service from your medical group or health plan.
Primary Care Doctor. For those enrolled in a PPO (preferred provider organization) or EPO (exclusive provider organization) plan, your health insurance company has matched you with a primary care doctor. You can change to another one at any time you choose.
We are reporting the broadest provider definition (designated by health insurer as a primary care provider) with all services, unclear if provider organizations were included or not.
Your primary care physician will help you navigate the health care system when you need assistance selecting the proper specialist, coordinating your care with other providers or when you need help understanding your treatment options.
