提供者手册

执业状态变更通知

Providers must immediately notify the Carelon Engagement Center in writing, to the attention of the Network Management Department, upon the occurrence of any of the following:

1. 地址变更、名称变更或合并，和/或新的税号。请使用“地址更新表“ 或者 ”申请纳税人识别号表格”提交更改时。这些表格也可以传真至 1-855-541-5211。
2. Revocation, suspension, restriction, termination, or voluntary relinquishment of any of the licenses, authorizations, or accreditations required by the Carelon agreement
3. 任何因专业疏忽而未决的法律诉讼，可合理地被认为是重大损失或意外事件，以及诉讼的最终处置
4. 对重罪或与个人或机构的专业实践相关的任何刑事指控的任何起诉、逮捕或定罪
5. 职业责任保险范围的任何失效或重大变化；
6. 限制、暂停、撤销或自愿放弃医务人员在任何医疗机构的会员资格或临床特权
7. 导致设施或办公室暂时关闭的任何情况；或者
8. 严重传染病的爆发

Carelon recognizes that members have a basic right to privacy of their personal information and records. Access to member information lies solely with the member except in the case of a parent or guardian with legal custody of a minor child, or a person with legal authority to act on behalf of an adult or emancipated minor in making decisions related to health care.