Definition of extension of care
When a member is undergoing an active course of treatment for a chronic or acute medical condition, access to care is granted through the current period of active treatment or for up to 90 calendar days, if the terminating practitioner accepts the terms of the fee schedule during the 90-day extension of care period. If the practitioner doesn't accept fee schedule, Priority Health will not offer extension of care to members in active care.
When the member is in the second or third trimester of pregnancy, access is granted through the postpartum period.
Priority Health ensures continuity and coordination of care to its members by:
- Notifying members of the pending terminations of practitioners or practice sites
- Assisting members with selecting a new practitioner
