Provider Access Changes Clause Samples
The Provider Access Changes clause defines the conditions under which a service provider may alter, restrict, or expand access to their services or systems. Typically, this clause outlines the process for notifying clients of changes, the types of access modifications that may occur, and any limitations or exceptions that apply. For example, it may allow the provider to temporarily suspend access for maintenance or security reasons, or to update user permissions as needed. The core function of this clause is to give the provider flexibility to manage their services effectively while informing clients of potential disruptions or changes, thereby reducing disputes and ensuring operational continuity.
Provider Access Changes. The MCO shall not make any substantive changes in its method of Provider access during the term of this Contract, unless approved in advance by the STATE. For the purposes of this section, a substantive change in the method of Provider access means a change in the way in which an Enrollee must choose his or her Primary Care Provider (clinic) and his or her physician specialists. Examples of methods of Provider access include but are not limited to: 1) Enrollee has open access to all Primary Care Providers (clinics); 2) Enrollee may self-refer to a physician specialist; 3) Enrollee must choose one Primary Care Provider (clinic); and 4) Enrollee must receive a referral to a physician specialist from his or her Primary Care Provider (clinic). For the purposes of this section, a substantive change in the method of Provider access shall not include the addition or deletion of Service Authorization requirements for services.
Provider Access Changes. The HEALTH PLAN shall not make any substantive changes in its method of provider access during the term of this Contract, unless approved in advance by the STATE. For the purposes of this Section, a substantive change in the method of provider access means a change in the way in which an Enrollee must choose his/her Primary Care Provider and his/her physician specialists. Examples of methods of provider access include but are not limited to: Enrollee has open access to all Primary Care Providers; Enrollee may self-refer to a physician specialist; Enrollee must choose one Primary Care Provider; Enrollee must receive a referral to a physician specialist from his/her Primary Care Provider. For the purposes of this Section, a substantive change in the method of provider access shall not include the addition or deletion of Prior Authorization requirements for services.