Coordination of Care
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
The primary care physician (PCP) is responsible for supervision of physician extenders, providing ongoing care and coordination of all services the member receives. The provider must verify any suspected serious medical condition (for example, heart murmur, scoliosis and developmental problems). If needed services fall outside the PCP's scope of practice, referrals must be made and treatment initiated within 60 days after the health assessment appointment at which the condition was identified. The Health Net Medi-Cal Health Services Department is available to provide coordination, if indicated by the member's condition and requested by the PCP.
Physician extenders may not be barriers to a request to see a physician. Any member being cared for by a physician extender must be given an appointment with the PCP without having to work through the physician extender.
Health Net's public program administrator specialists receive information from the Health Net Medi-Cal Member Services Department regarding members who have disenrolled. If a member disenrolls, services are stopped.
If members in need of transportation assistance do not meet the criteria for non-emergency transportation, the PCP refers the member to Public Programs for assistance with transportation.