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Discharge of a Member from Participating Provider's Care - Neighborhood Health Partnership Supplement, 2018 UnitedHealthcare Administrative Guide

If, after reasonable effort, the PCP is unable to establish and maintain a satisfactory relationship with a member, the PCP may request that the member transfer to another PCP. The PCP must submit the request in writing to NHP Member Care. Reasons for discharge may include:

  • Disruptive behavior
  • Physical threats/abuse
    • This warrants immediate action, which must be documented. Please contact NHP Member Care and notify the proper authorities.
  • Verbal abuse
  • Gross non-compliance with the treatment plan

The PCP must provide adequate documentation in the member’s medical record of the verbal and written warnings. The PCP is obligated to provide care to the member until it is determined that the member is under the care of another physician.