Primary care provider definition

Primary care provider means a participating provider who supervises, coordinates, or provides initial care or continuing care to a covered person, and who may be required by the health carrier to initiate a referral for specialty care and maintain supervision of health care services rendered to the covered person.
Primary care provider. (PCP) means, for the purpose of this plan, professional providers that are family practitioners, internists, and pediatricians. For the purpose of this plan, gynecologists, obstetricians, nurse practitioners, and physician assistants may be credentialed as PCPs. To find a PCP or check that your provider is a PCP, please use the “Find a Doctor” tool on our website or call Customer Service.
Primary care provider means any of the following who provide primary care and meet certification standards:

Examples of Primary care provider in a sentence

  • Services Performed by the Primary Care Provider‌ The Member’s Primary Care Provider is responsible for providing and arranging for the Member’s health care except for Urgent Care or Emergency Services.

  • The Plan generally requires the designation of a Primary Care Provider (PCP).

  • For Dependent children, the Member may designate any In-Network provider who specializes in pediatric care as their Primary Care Provider (PCP).

  • Any selection of a new Primary Care Provider must be communicated to and approved by The Plan and the change will be effective the first of the Month following the request.

  • Any follow-up care after Urgent Care or Emergency Services should be coordinated by the Member’s Primary Care Provider.


More Definitions of Primary care provider

Primary care provider means any health care practitioner involved in the diagnosis and treatment of a patient’s debilitating medical condition.
Primary care provider means a nurse practitioner, physician, or physician assistant.
Primary care provider means a natural or legal person who holds a Primary Care Contract, or is a Pharmaceutical Services Provider; Primary Care Provider Personnel means all persons (whether clinical or non-clinical) employed or engaged by a Primary Care Provider or by any Sub-Contractor (including volunteers, agency, locums, casual or seconded personnel) in the provision of Services or any activity related to or connected with the provision of the Services;
Primary care provider or “PCP” A practitioner who provides preventive and primary medical care for eligible members and who certifies service authorizations and referrals for all medically necessary specialty services. PCPs may include pediatricians, family and general practitioners, internists, obstetrician/gynecologists, and specialists who perform primary care functions such as surgeons, clinics including, but not limited to health departments, Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), etc.
Primary care provider means the health care provider primarily responsible for the on-going diagnosis and treatment of the resident where they currently reside.
Primary care provider or “PCP” means a qualified physician, or certified nurse practitioner or team of no more than four (4) qualified physicians/certified nurse practitioners which provides all required primary care services contained in the Benefit Package to Enrollees.
Primary care provider means a physician, physician's assistant or nurse practitioner that provides regular and continuous health care services.