PMP Responsibilities
The Hoosier Healthwise program encourages eligible members to select a PMP to provide, through an ongoing patient/PMP relationship. The PMP provides or authorizes most preventive and primary medical care.
- Case Management
As part of the case management function, PMPs are expected to provide or authorize most primary and preventive care services. PMPs who authorize another provider to render services must document the referral (PMP authorization) in the patient's medical record. Some medical services do not require PMP authorization. Members may gain access to these services through self-referral, or PMPs may suggest to members how to access these services. - 24 Hour Availability
The PMP, or a clinically qualified designee, must be available 24-hours a day, seven days a week, and must assume management of the member's health and medical needs. - 20 Hours per Week Access (minimum)
Primary care physicians in any setting(s) 20 hours a week over 3 days are eligible to be PMPs, and may serve as the PMP for any member within their normal scope of practice. - Provider Directory Listing
Physicians who enroll in this program agree to be listed as a PMP in the Hoosier Healthwise Provider Directory.
