What is a "come-along provider"?

The term "come-along provider" refers to a provider who continues treatment for a patient even after the patient transitions to a Managed Care Organization (MCO). This means that the provider is willing to accept the terms and coverage provided by the MCO in order to maintain continuity of care for the patient. This is particularly important in ensuring that patients do not experience gaps in treatment and can receive consistent medical attention tailored to their individual needs.

This concept is relevant in the context of managed care systems, where patients often face restrictions on which providers they can see based on the MCO's network. A come-along provider helps bridge the transition for patients, making it less disruptive and more beneficial for their ongoing care.

Understanding the role of come-along providers is crucial for claims adjusters as it relates to patient outcomes and impacts how claims may be handled in situations involving ongoing treatment needs.