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C. All denials for retrospective review are sent to Providers within five working days of making
the decision
CONTINUITY OF CARE
Bravo Health’s policy is to provide for continuity of and coordination of care among medical
practitioners treating the same patient, coordination between medical and behavioral care and to
minimize potential continuity problems caused when a practitioner leaves a network and has patients in
active treatment.
Any Member who is currently undergoing treatment upon the termination of a Provider for reasons
other than those associated with quality of care or a Member who is new to Bravo Health may be
allowed to continue care with their current Provider for up to 90 days from the date the enrollee is
notified by the plan of the termination or pending termination of a Contracting Provider. Members
undergoing active treatment for a chronic or acute medical condition will have access to such
discontinued Provider through the current period of active treatment for up to 90 calendar days,
whichever is shorter. Members in their second or third trimester of pregnancy have access to their
discontinued practitioner through the postpartum period. If Bravo Health terminates a Contracting
Provider for cause, Bravo Health will not be responsible for the health care services provided by the
terminated Provider to the enrollee following the date of termination.
Members with previously scheduled treatments or procedures and Members in the middle of an episode
of care may be allowed to continue care with their current Provider for up to 90 days from the date the
Member is notified by Bravo Health of the termination or pending termination of a healthcare Provider.
