4 ACCESS TO CARE
4.3 Covering Physicians
During a provider’s absence or unavailability, the provider must arrange for coverage for his or her members. The provider will either: 1) make arrangements with one or more IntegraNet network providers to provide care for his or her members or 2) make arrangements with another similarly licensed and qualified provider who has appropriate medical staff privileges at the same network hospital or medical group, as applicable, to provide care to the members in question.
In addition, the covering provider will agree to the terms and conditions of the network provider agreement, including any applicable limitations on compensation, billing and participation. Providers will be solely responsible for a non-network provider’s adherence to such provisions. Providers will be solely responsible for any fees or monies due and owed to any non-network provider providing substitute coverage to a Medicare member on the provider’s behalf.