fbpx

Primary Care Providers (PCP) at Neighborhood

July 2021

Neighborhood’s primary care providers (PCP) ensure comprehensive, first-person centered care. PCPs practice in the following areas of medicine:

  • Pediatrics, Obstetrics and Gynecology, Family Practice, Internal Medicine
  • Nurse practitioners and physician assistants can be credentialed as PCPs at Neighborhood

 

In choosing to participate with Neighborhood, PCPs have accepted the following responsibilities:

  • Develop, maintain and monitor a Plan of Care for each member and arrange for the furnishing of covered services, including admissions to inpatient facilities and coordination between medical and behavioral health services.
  • Establish and maintain medical records for each member that are consistent with current professional standards and medical requirements and as may be set forth in applicable statutes and regulations of the State of Rhode Island.
  • Make and maintain necessary arrangements to ensure the availability of PCP services to members twenty-four (24) hours a day, seven (7) days a week.
  • Establish and maintain after-hours and on-call arrangements, as necessary.
  • Be open for operations five (5) days per week/per site, with a minimum appointment time of forty hours (40) per week/per site, including a minimum of six (6) additional evening or weekend hours. Exceptions will be considered by Neighborhood’s Chief Medical Officer based on the site’s ability to provide documented continuity of care and access to services policies and procedures for routine and urgent medical conditions.
  • Designated PCP’s who have member panels must be available a minimum of seventeen and one-half (17.5) hours of appointment time per week.
  • Maintain policies and procedures for ongoing patient education including, but not limited to, orientation to provider’s services, self-management of medical problems, disease prevention and a presentation of a written patient bill of rights.
  • Coordinate, when required, medically necessary emergency services on behalf of members.
  • Provide and administer care and services in accordance with accepted medical practices and professional standards of behavior as set forth by the American Medical Association, The American Osteopathic Association, and the laws governing medical practice in the State of Rhode Island.
  • Ensure that early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services are provided to all eligible children and young adults up to the age of 21.
  • Ensure that all covered services are available and provided at such times and places, including the member’s home or elsewhere, as necessary and practical.
  • Ensure the member’s right to consent to or deny the release of identifiable medical or other information, except when such release is not required by law.
  • Ensure the member’s right to refuse treatment without jeopardizing future treatment and the member’s right to ask for a second opinion in accordance with Neighborhood’s policies and procedures.

 

For more information, please consult Neighborhood’s Provider Manual.