Women’s Health Specialist Sample Clauses

Women’s Health Specialist. If a female Enrolled Member’s designated Primary Care physician is not a women’s health specialist, Contractor shall provide the Enrolled Member with direct Access to a women’s health specialist within the Provider Network for covered routine and preventive women’s Health Care Services. See: 42 C.F.R. § 438.206(b)(2); 42 C.F.R. § 457.1230(a). {From CMSC F.4.01}.
Sample 1
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Women’s Health Specialist. In addition to a primary care provider, a female member may have a women’s health specialist. The HMO must provide female members with direct access to a women’s health specialist within the network for covered women’s routine and preventive health care services. A PCP must be within a 30 minute drive time of any member residing in these counties. Pediatric 090 – Certified Pediatric Nurse Practitioners 092 – Certified Family Nurse Practitioners 093 – Other Nurse Practitioners 100 – Physician Assistants 316 – Family Practice 318 – General Practice 322 – Internal Medicine 345 – Pediatricians 080 – Federally Qualified Health Center (HealthCheck related) 734 – Screener (HealthCheck) 735 – Screener/Case Management (HealthCheck)
Sample 1
Women’s Health Specialist. In addition to a primary care provider, a female member may have a women’s health specialist. The HMO must provide female members with direct access to a women’s health specialist within the network for covered women’s routine and preventive health care services. A PCP must be within a 60 minute drive time of any member residing in all other counties. Pediatric 090 – Certified Pediatric Nurse Practitioners 092 – Certified Family Nurse Practitioners 093 – Other Nurse Practitioners 100 – Physician Assistants 316 – Family Practice 318 – General Practice 322 – Internal Medicine 345 – Pediatricians 080 – Federally Qualified Health Center (HealthCheck related) 734 – Screener (HealthCheck) 735 – Screener/Case Management (HealthCheck) These access standards do not prevent a member from choosing a HMO when the member resides in a county that does not meet the distance standard. However, the member will not be automatically assigned to that HMO. If the member has been assigned to the HMO or has chosen the HMO and becomes dissatisfied with the access to medical care, the member may disenroll for cause from the HMO because of distance.
Sample 1
Women’s Health Specialist. In addition to a primary care provider, a female member may have a women’s health specialist. The PIHP must provide female members with direct access to a women’s health specialist within the network for covered women’s routine and preventive health care services. A PCP must be within a 30 minute drive time of any member residing in these counties. Pediatric 090 – Certified Pediatric Nurse Practitioners 092 – Certified Family Nurse Practitioners 093 – Other Nurse Practitioners 100 – Physician Assistants 316 – Family Practice 318 – General Practice 322 – Internal Medicine 345 – Pediatricians 080 – Federally Qualified Health Center (HealthCheck related) 734 – Screener (HealthCheck) 735 – Screener/Case Management (HealthCheck) The PIHP must have a sufficient number of primary care providers in the network with pediatric board certification or eligibility and experience working with children with special health care needs so that each child is served. In Milwaukee County, there must be a sufficient number of primary care providers in all zip codes in the county.
Sample 1
Women’s Health Specialist. In addition to a primary care provider, a female member may have a women’s health specialist. The PIHP must provide female enrollees with direct access to a woman’s health specialist within the network for covered women’s routine and preventive health care services.
Sample 1

Related to Women’s Health Specialist

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