16.5.2.4 If yes to 16.5.2.3, provide the following details: Methodology for patient identification and selection, such as consideration of patient residence, language proficiency Referral procedure for identified patients Accommodations for patients not residing in close proximity to a recognized higher volume provider 200 words. 16.5.3 Network Stability All questions required for existing Exchange networks and newly proposed networks. If network has been proposed for products offered in the Individual Exchange, this section is not required for that network. 16.5.3.1 Total Number of Contracted Hospitals: No space for details provided. Integer. 16.5.3.2 Identify network hospitals terminated between January 1, 2017 and December 31, 2017 , including any hospitals that had a break in maintaining a continuous contract during this period. Indicate reason for hospital termination: non-agreement on rates, non-compliance with contract provisions, and redesign of network or other (explain). Applicants with no prior California presence must use out of state experience. No space for details provided. Name of Terminated Reason Reinstated Terminated by: Hospital 10 words. Single, 20 10 words. Nothing list. words. Nothing required Nothing required 1: Applicant, 2: Hospital, required 3: N/A 10 Single, 20 10 Nothing list. words. Nothing required Nothing required 1: Applicant, 2: Hospital, required 3: N/A 10 words. Single, 20 10 words. Nothing list. Nothing Nothing required required required 1: Applicant, 2: Hospital, 3: N/A 10 words. Single, 20 10 words. Nothing list. words. Nothing required Nothing required 1: Applicant, 2: Hospital, required 3: N/A
16.5.2.4 If yes to 16.5.2.3, provide the following details: Methodology for patient identification and selection, such as consideration of patient residence, language proficiency Referral procedure for identified patients Accommodations for patients not residing in close proximity to a recognized higher volume provider 200 words. 16.5.3 Network Stability All questions required for existing Exchange networks and newly proposed networks. If network has been proposed for products offered in the Individual Exchange, this section is not required for that network. 16.5.3.1 Total Number of Contracted Hospitals: No space for details provided. Integer. 16.5.3.2 Identify network hospitals terminated between January 1, 2017 and December 31, 2017 , including any hospitals that had a break in maintaining a continuous contract during this period. Indicate reason for hospital termination: non-agreement on rates, non-compliance with contract provisions, and redesign of network or other (explain). Applicants with no prior California presence must use out of state experience. No space for details provided. Name of Terminated Hospital Terminated by: Reason Reinstated 10 words. Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 words. Nothing required 10 words. Nothing required 10 Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 words. Nothing required 10 Nothing required 10 words. Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 Nothing required 10 words. Nothing required 10 words. Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 words. Nothing required 10 words. Nothing required
CCSB%20QHP%20Certification%20Application%20Plan%20Year%202019%20Quarterly%20Application_Final.docx