Encouraging Consumers’ Access to Appropriate Care. Contractor is encouraged to assist Exchange Enrollees in selecting a primary care dentist or Federally Qualified Health Center that provides dental care within sixty (60) days of enrollment. In the event the Enrollee does not select a primary care dentist within the allotted timeframe, Contractor may auto-assign the enrollee to a primary care dentist and the assignment shall be communicated to the Plan Enrollee. In the event of an auto-assignment, Contractor shall use commercially reasonable efforts to make the primary care dentist assignment consistent with an Enrollee’s stated gender, language, ethnic and cultural preferences, if known, and should consider geographic accessibility and existing family member assignment or prior provider assignment.
Encouraging Consumers’ Access to Appropriate Care. Contractor is encouraged to assist Enrollees in selecting a Primary Care Provider, Federally Qualified Health Center or a Patient-Centered Medical Home (PCMH) within sixty (60) days of enrollment. In the event the Enrollee does not select a primary care provider (PCP) within the allotted timeframe, Contractor may auto-assign the enrollee to a PCP and the assignment shall be communicated to the Plan Enrollee. In the event of an auto- assignment, PCP assignment will be consistent with an Enrollee’s stated gender, language, ethnic and cultural preferences, and will consider geographic accessibility and existing family member assignment or prior provider assignment.
Encouraging Consumers’ Access to Appropriate Care. Contractor is encouraged to assist Exchange Enrollees in selecting a Primary Care Provider (PCP), Federally Qualified Health Center (FQHC) or a Patient-Centered Medical Home (PCMH) within sixty (60) days of enrollment. In the event the Enrollee does not select a PCP, FQHC or a PCMH, Contractor may auto-assign the enrollee to a PCP, FQHC or a PCMH and the assignment shall be communicated to the Plan Enrollee. Nothing in this section shall be construed to prohibit Contractor from assigning an Enrollee to a PCP, FQHC or a PCMH prior to the expiration of the sixty (60) day self-selection period. In the event of an auto-assignment, Contractor shall use commercially reasonable efforts to make assignment to a participating provider consistent with an Enrollee’s stated gender, language, ethnic and cultural preferences, and will consider geographic accessibility and existing family member assignment or prior provider assignment.
Encouraging Consumers’ Access to Appropriate Care. Contractor is encouraged to assist Covered California Enrollees in selecting a primary care dentist, dental clinic, or Federally Qualified Health Center that provides dental care within sixty (60) days of enrollment. In the event the Enrollee does not select a primary care dentist within the allotted timeframe, Contractor may auto-assign the enrollee to a primary care dentist and the assignment shall be communicated to the Plan Enrollee. The Contractor will also make reasonable effort to notify the primary care dentist of the Enrollee assignment. In the event of an auto-assignment, Contractor shall use commercially reasonable efforts to make the primary care dentist assignment consistent with an Enrollee’s stated gender, language, ethnic and cultural preferences, if known. It is recommended that consideration be given to, geographic accessibility and existing family member assignment or prior provider assignment.
Encouraging Consumers’ Access to Appropriate Care. Contractor is encouraged to assist Exchange Enrollees in selecting a primary care dentist or Federally Qualified Health Center that provides dental care within sixty (60) days of enrollment. In the event the Enrollee does not select a primary care dentist within the allotted timeframe, Contractor may auto-assign the enrollee to a primary care dentist and the assignment shall be communicated to the Plan Enrollee. The Contractor will also make reasonable effort to notify the primary care dentist of the Enrollee assignment. In the event of an auto- assignment, Contractor shall use commercially reasonable efforts to make the primary care dentist assignment consistent with an Enrollee’s stated gender, language, ethnic and cultural preferences, if known, and should consider geographic accessibility and existing family member assignment or prior provider assignment.
