Policy: All WKCC primary providers, regardless of full-time employment status, are required to meet core requirements and participate in PODs. Exceptions to this policy may be granted in certain cases with approval from the WKCC Board. All requests must be made in writing via the exception request form to the Network & Credentialing committee.
“Primary Care Provider” includes any provider meeting the AMA definition of a primary care provider:
(I) is a physician (as described in section 1861(r)(1)) who has a primary specialty designation of family medicine, internal medicine, geriatric medicine, or pediatric medicine; or
(II) is a nurse practitioner, clinical nurse specialist, or physician assistant (as those terms are defined in section 1861(aa)(5)); and
(ii) for whom primary care services accounted for at least 60 percent of the allowed charges under this part for such physician or practitioner in a prior period as determined appropriate by the Secretary