Section R20-6-1813. Assignment of Members

A.      Within 30 days of enrollment, an Organization shall assign a member to the provider the member chooses. The Organiza- tion, however, shall choose and assign a provider to a member within 30 days of any of the following:

1.        Receipt of a member enrollment form that does not desig- nate a provider, or receipt of a member enrollment form that designates a provider who is unavailable;

2.        The date of the notice that the member’s assigned pro- vider intends to cease providing services; or

3.        The   date  the   member’s  assigned   provider  becomes unavailable, for any reason.

B.       An Organization shall give each member the option of select- ing a network provider other than the provider assigned by the Organization under subsection (A).

C.      An Organization shall maintain a continuous assignment pro- cess in compliance with subsection (A) and (B), allowing no more than 4% of members to be unassigned at any time.

Historical Note

New Section made by final rulemaking at 8 A.A.R. 463, effective January 10, 2002 (Supp. 02-1).