Provider offices are encouraged to review and understand the requirements for accepting new patients and closing patient panels.
Information on updating demographic profiles and the process for closing panels can be found in the Provider Manual for Participating Professional Providers available on our Provider News Center.
Accepting new patients
Primary care providers (PCPs) should have current information relating to their practice(s) and accepting new patients. Capitated providers must continue accepting new patients until they have met the minimum number of patients required for their patient panel.
The minimum number of patients required in a provider's patient panel is stated as part of the terms of their Professional Provider Agreement.
Closing a PCP practice to additional patients
A participating PCP must notify Provider Network Services at least 60 days in advance of any intent to close the practice to additional patients. Close-of-practice notification should be in writing and addressed to Provider Network Services at firstname.lastname@example.org.
The three status levels for offices are:
- Open: Practice is accepting new patients.
- Current: Practice is accepting existing patients currently in the practice but covered by another insurance.
- Frozen/Closed: Practice is not accepting additions to the HMO or POS panel. Providers in this category do not appear in the Provider Directory. one that is not accepting additions to the HMO or POS panel. Providers in this category do not appear in the Provider Directory.
Additional information on accepting new patients and closing patient panels can be found in the Administrative Procedures section of the Provider Manual for Participating Professional Providers.