Provider Services and Responsibilities PROVIDER shall Sample Clauses

Provider Services and Responsibilities PROVIDER shall. A. Provide case management services and primary care services for IO IP members assigned to PROVIDER’s panel. Case management means: i) coordinating and monitoring all medical care for panel members; ii) making medically necessary specialty referrals for panel members, including standing referrals (i.e. a PCP referral for a member needing to access multiple appointments with a specialist over a set period of time (such as a year), without seeking multiple referrals that may include a limitation on the frequency or number of visits; iii) coordinating panel members’ admissions to the hospital; iv) making appropriate referrals to the Women, Infants and Children (WIC) program; v.) coordinating with mental health professionals involved in panel members’ care; vi.) educating panel members to appropriately use medical resources such as the emergency room;