Common use of Primary Care Provider Clause in Contracts

Primary Care Provider. As set out in Ohio Administrative Code §5160-26-01(FF), an individual physician (M.D. or D.O.), a physician group practice, an advanced practice registered nurse as defined in section 4723.1 of the Ohio Revised Code, and advanced practice nurse group practice within an acceptable specialty, or a physician assistant who meets the requirements of rule 5160-4-03 of the Ohio Administrative Code contracting with ACOH to provide services as specified in OAC Rule 5160-26-03. 1. Acceptable PCP specialty types include family/general practice, internal medicine, pediatrics, and obstetrics/gynecology (OB/GYN). Without limiting the applicability of OAC 5160-26-03.1, the PCP is responsible for the supervision, coordination, and provision of primary care services to Members who have selected, or have been assigned to, that provider. The Primary Care Provider also is responsible for initiating any required referrals for specialty care needed by a Member and maintaining overall continuity of a Member’s care.