Common use of Encouraging Consumers’ Access to Appropriate Care Clause in Contracts

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 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 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 will be consistent with an Enrollee’s stated gender, language, ethnic and cultural preferences, if known, and will should consider geographic accessibility and existing family member assignment or prior provider assignment.