Common use of The Primary Care Physician Clause in Contracts

The Primary Care Physician. The PCP coordinates a Member's medical care, as appropriate, either by providing treatment or by issuing Referrals to direct the Member to a Participating Provider. The PCP can also order lab tests and x-rays, prescribe medicines or therapies, and arrange hospitalization. Except in a Medical Emergency or for certain direct access Specialist benefits as described in this Certificate, only those services which are provided by or referred by a Member’s PCP will be covered. Covered Benefits are described in the Covered Benefits section of this Certificate. It is a Member’s responsibility to consult with the PCP in all matters regarding the Member’s medical care. If the Member’s PCP performs, suggests, or recommends a Member for a course of treatment that includes services that are not Covered Benefits, the entire cost of any such non-covered services will be the Member’s responsibility.