Selection of a Primary Care. Provider (PCP)
Selection of a Primary Care. PHYSICIAN Prior to the time a Member's coverage becomes effective in accordance with the provisions of this Agreement, the Member must choose a Participating Primary Care Physician (PCP) in the network for Keystone’s Approved Service Area from whom the Member wishes to receive Covered Services under this Agreement. If the Member is a minor or otherwise incapable of selecting a PCP, the Subscriber or legal guardian should select a PCP on the Member's behalf. A Member may designate any Participating Primary Care Physician who is available to accept Members as the Member’s Primary Care Physician. If the Member is a minor, the Subscriber or legal guardian may select a pediatrician as the Member’s PCP. At the new Member's option and subject to the Nonparticipating Provider's agreement to certain terms and conditions, the Member may continue an ongoing course of treatment with a Nonparticipating Provider for a period of up to ninety (90) days from the Member's Effective Date of Coverage (See Continuity of Care provision below). If a Member fails either to select a Primary Care Physician or complete a Continuity of Care form within thirty (30) days of Membership, the HMO reserves the right to assign a Member to a Primary Care Physician subject to the Member’s right to change Primary Care Physicians as described below.
