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h. To notify Bravo Health Member Services and their Providers of any address and phone number
changes as soon as possible.
i. To use their Bravo Health plan only to access services, medications and other benefits for
themselves.
ADVANCE MEDICAL DIRECTIVES
All Providers, contracted directly or indirectly with Bravo Health, may be informed by the Member
that Member has executed, changed or revoked an advance directive. At the time service is provided
the Provider should ask the Member to provide a copy of the advance directive to be included in
his/her medical record.
If the PCP and/or treating Provider, cannot, as a matter of conscience, fulfill the Member’s written
advance directive he/she must advise the Member and Bravo Health. Bravo Health and the PCP
and/or treating Provider will arrange a transfer of care.
Participating Providers may not condition the provision of care or otherwise discriminate against an
individual based on whether the individual has executed an advance directive. However, nothing in
The Patient Self-Determination Act precludes the right under state law of a Provider to refuse to
comply with an advance directive as a matter of conscience.
BENEFITS AND SERVICES
All Bravo Health Members receive the benefits and services as defined in their Evidence of Coverage
(EOC). Each month, Bravo Health sends Participating Primary Care Physicians a list of his/her
active Members. The name of the Plan in which the Member enrolled will be listed on the roster.
Recently terminated Members may appear on the list.
Bravo Health encourages its Members to call their Primary Care Physician to schedule appointments.
However, if a Bravo Health Member calls or comes to your office for an unscheduled non-emergent
appointment, please attempt to accommodate the Member and explain to them your office policy
regarding appointments. If this problem persists, please contact Bravo Health.
THE ROLE OF THE PRIMARY CARE PHYSICIAN (“PCP”)
Each Bravo Health Member must select a Bravo Health Participating Primary Care Physician (“PCP”)
at the time of enrollment. The Primary Care Physician is responsible for managing all the health care
needs of a Bravo Health Member as follows:
• Manage the health care needs of Bravo Health Members who have chosen them as their Primary
Care Physician;
• Ensure that Member receives treatment as frequently as is necessary based on the Member’s
condition;
• Develop an Individual Treatment Plan for each Member;
• Submit accurately and timely encounter information for clinical care coordination;
• Comply with Bravo Health’s pre-authorization procedures;
• Refer to Bravo Health Participating Providers;
