4688.0080 Information To Enrollees

Published: 2015

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A health plan company shall inform its enrollees that designated ECPs are available to provide designated services to uninsured persons, high risk and special needs populations, and underserved and other special needs populations. The health plan company shall clearly inform enrollees how to access services at an ECP, including which services require prior authorization, and how to obtain prior authorization. Enrollees shall be provided with a toll-free telephone number to call the member services section of the health plan company with questions about access to ECPs.