It's not strictly necessary, but it might prevent a clash of rights and duties. Actually, the basic CI contract (without an SA rider) says that, if the member has a funded contract, our responsibility begins when he is delivered to CI. If the member/patient made arrangements with SA to do its thing and then deliver him to CI, and notify only SA when the need arose, that could work. But then of course problems could arise if the prior SA activities involved any legal questions.