Second Opinions from PCP or specialist

A member or the member’s PCP or specialist may request a second opinion for serious medical conditions or elective surgical procedures. The conditions and/or procedures include, but are not limited to, the following: • Treatment of serious medical conditions, such as...

Specialist as a PCP

Under certain circumstances, a specialist may be approved by Prestige Health Choice to serve as a member’s PCP when a member requires the regular care of the specialist. The criteria for a specialist to serve as a member’s PCP include the existence of a chronic,...

PCP roles and responsibility

36. The provider agrees that provisions will be made to minimize sources and transmission of infection. 37. The provider agrees to maintain communication with the appropriate agencies such as local police, social services agencies and poison control centers to provide...

who is pcp – primary care provider

The network primary care provider (PCP) is responsible for the complete care of his or her members, whether providing directly or by referral to the appropriate provider of care within the network and as such, accepts all associated case management responsibilities....