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7.5.8.7 Additional Criteria for Primary Care Providers
All PCCM primary care providers must meet credentialing/recredentialing criteria. Primary care providers are also required to meet the following criteria:
• Ability to Perform or Supervise the Ambulatory Primary Care Services of Clients. Provider performance is monitored on an ongoing basis. The PCCM Administrator follows up on evidence of poor performance and addresses identified problems immediately to ensure that high-quality care is delivered to clients.
•Admitting Privileges. The primary care provider must maintain admitting privileges with a hospital which is a participating provider in PCCM, or make arrangements with another Texas licensed physician who is an eligible Medicaid provider and who maintains admitting privileges with a contracted PCCM hospital.
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