7.5.8.6 Primary Care Provider Termination/DisenrollmentPrimary care providers may terminate the PCCM agreement by providing 90 days prior written notice. Ninety days prior notice is requested to allow sufficient time to complete the reassignment process of clients in a primary care provider's panel to new primary care providers. Individual provider agreements will terminate automatically upon a provider's death, the sale of the provider's practice, or termination as a participant in the Texas Medicaid Program. HHSC may terminate a provider agreement by providing 30 days prior written notice. An HHSC initiated provider termination would be instituted for a provider who does not consistently meet plan requirements. Refer to: "Monitoring Provider Performance" Clinics must notify PCCM within 30 days when a provider employee leaves the employ of or terminates his contract with the clinic, or is no longer willing to function as a primary care provider. Termination or disenrollment notification should be sent to the following address:
Primary Care Case Management (PCCM) All correspondence must include the primary care provider's contracted provider identifier on signed letterhead or providers should contact the Provider Enrollment/Contracting and Credentialing Department at 1-800-925-9126, option 2, to request a Provider Information Change (PIC) form. Refer to: "Provider Information Change Form". |
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Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved. |
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