If a situation arises when a primary care physician (PCP) or other treating
physician initiates termination of its physician-patient relationship and needs
to release an Independence member from his or her practice, there are some
important things to remember. The PCP or treating physician must notify both
the member and Independence in writing if terminating a member from his or her
practice. To notify Independence, the physician must contact his or her Network
Coordinator or Customer Service, or send correspondence to:
- Independence Blue Cross
- Attn: Network Services
- 1901 Market Street, 28th Floor
- Philadelphia, PA 19103
The physician must also continue treating the member for current medical
conditions for 30 days after ending the physician-patient relationship to allow
time for the member to select a different treating physician. During this time,
we will assist the member in selecting a different PCP or other treating
physician. If the member asks the physician or office staff for assistance in
selecting a new PCP or other treating physician, he or she should be referred
to Customer Service at 1-800-ASK-BLUE. In the event the member
is threatening or violent towards the physician or office staff, the member?s
access to the office may be terminated immediately.
Non-discrimination
Physicians cannot discriminate against any member on the basis of the
member?s coverage under a benefit program, age, sex, race, color, religion,
ancestry, national origin, disability, handicap, health status, source or
amount of payment, or utilization of medical or mental health services or
supplies. Other unlawful reasons for discharging a member, without limitation,
include the filing by such member of any complaint, grievance, or legal action
against the provider or Independence. Participating physicians are also
prohibited from excluding or closing a practice to certain members as a result
of the reimbursement (e.g., closing a practice to capitated HMO patients only).
Physicians are also not permitted to terminate their relationship with a member
who has complicated or expensive medical needs unless the provider has received
written approval from Independence that there is good cause for such
termination and that such termination is in the member?s best interest.
Medical record requests
When a provider initiates termination of the physician-patient relationship
with the member, the physician cannot charge members for requests for copies of
medical records. The physician must facilitate the sharing of such records
among health care providers directly involved with the member?s care.