Consumer Access to Service and Information
The CIN ensures the payor meets regulatory geo-access requirements in the payor agreements, found in the health plan CIN risk agreements that the health plan attests their network meets access and availability standard.
Provider directs the patient to the emergency room as medically appropriate during regular business hours or after hours. The provider will complete annually in the Provider Office Checklist.
Referrals and Utilization of Participating Provider. For all Plans, except as prohibited by law, Provider agrees to refer, and/or admit or arrange for admission of Members only to Participating Provider hospitals and facilities (including, but not limited, to surgery centers), and other Participating Providers directly contracted with CIN or payor unless the referral, and/or admission is either authorized in advance by the payor, or in cases of Emergency Services.
For the purpose of providing quality care to Members, Provider shall furnish to other physicians and providers treating a Member all relevant medical information, including treatments and diagnostic tests, related to such Member.
Non-Discrimination. Equitable Treatment of Members. Provider shall render Provider Services to Members with the same degree of care and skill as customarily provided to Provider’s patients who are not Members, according to generally accepted standards of medical practice. Provider and CIN agree that Members and non-Members should be treated equitably. Provider agrees not to discriminate against Members on the basis of race, ethnicity, gender, creed, ancestry, lawful occupation, age, religion, marital status, sexual orientation, mental or physical disability, medical history, color, national origin, place of residence, health status, claims experience, genetic information, source of payment for services whether as a private purchaser of the plan or as participants in publicly financed programs of health care services, cost or extent of Provider Services required, Medicare beneficiary status, or on any additional grounds prohibited by law or this policy.