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How to See a Specialist
How
to See a Specialist | Direct
Access to Obstetrical/Gynecological Care | How
to Obtain a Standing Referral
How to Have
a Referred Specialist Designated as Your Primary Care Physician | How
to Plan For Hospital Care
Continuity of Care
Continuity of Care
If your child is in an ongoing course of treatment and:
- your child’s physician is no longer a participating provider because Keystone terminates its contract with that physician, for reasons other than cause; or
- your child is newly enrolled in the plan and is already in an ongoing course of treatment with a non-participating provider,
you have the option, if your child’s physician agrees to be bound by certain terms and conditions required by Keystone, to continue your child’s ongoing course of treatment with that physician for up to 60 days from:
- receipt of notice that the status of your child’s physician has changed; or
- your child’s effective date of coverage.
If your child is in her second or third trimester of pregnancy at the time of her enrollment or termination of a participating provider’s contract, the continuity of care with that physician will extend through post-partum care related to the delivery.
Follow these steps to initiate your child’s continuity of care:
- Call member services at 1-800-464-5437 and ask for a
“Request for Continuation of Treatment” form.
- The “Request for Continuation of Treatment” form will
be mailed or faxed to you.
- You must complete the form for your child and send it
to the patient care management department at the address
that appears on the form.
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