Plan Specialist definition

Plan Specialist means those independent licensed specialists who have contracted with the Plan to provide dental services for Members of the Plan that are of such a degree of complexity as not to be normally performed by a Participating Dentist. Plan Specialists are not employees of, nor supervised by the Plan.
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Plan Specialist means a dentist practicing in a dental specialty who is under contract with the plan to provide specialty services to you including, but not limited to: endodontics, orthodontics, pedodontics, periodontics, and oral surgery.
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Examples of Plan Specialist in a sentence

  • Trio+ SpecialistThe Member may arrange an office visit with a Trio+ Plan Specialist within their Primary Care Physician’s Medical Group/IPA without a referral from the Primary Care Physician.

  • Dental services which are not performed by the assigned PCD or properly referred to a DeltaCare Dental Plan Specialist will not be covered by the DeltaCare Plan.

  • In the event the Participating General Dentist determines specialty care is necessary, the Participating General Dentist will provide a referral to a Plan Specialist (if available).

  • The dental records of all Members concerning services performed hereunder shall remain the property of the Participating Dentist or Plan Specialist.

  • Covered Services include medical services rendered by a Plan Specialist or other duly licensed Plan Provider whose opinion or advice (i.e., second or third opinion or consultation) is requested by a Member's PCP or the Medical Director) for further evaluation of an Illness or Injury on an Inpatient or outpatient basis.

  • Bridge City Independent School District Application for Approval of Research Studies Involving District Students and/or Staff The researcher/investigator or responsible individual who will submit to BCISD the following form completed and information.

  • If you are requesting a second opinion about care received from a specialist, the second opinion may be provided by any Plan Specialist of the same or equivalent specialty.

  • Members may be referred to a Plan Specialist within the Dental Center.

  • TeleWealth services and Retirement Plan Specialist are offered through TCG Advisors, a HUB International company.

  • PARTICIPATING REFERRAL: Referrals to a Plan Specialist must be made by the Member's Participating Dentist, except in the case of orthodontics.NON-PARTICIPATING REFERRAL: If a Participating Dentist refers the Member to a nonparticipating specialist for dental services, which are covered under this agreement, the Plan shall be responsible for payment of the specialist's charges to the extent the charges exceed the Copayments specified in the Description of Benefits and Member Copayments.

Related to Plan Specialist

  • Benefits Specialist means a specialized position that would primarily be responsible for coordinating Client applications and appeals for State and Federal benefits.

  • Medical Specialist means any medical practitioner who is vocationally registered by the Medical Council under the Health Practitioners Competence Assurance Act 2003 in one of the approved branches of medicine and who is employed in either that branch of medicine or in a similar capacity with minimal oversight.

  • Housing Specialist means a specialized position dedicated to developing the full array of housing options for their program and monitoring their sustainability for the population served in accordance with the minimal housing standards policy set by the COUNTY for their program. The Housing Specialist is also responsible for assisting Participants with applications to low income housing, housing subsidies, senior housing, etc.

  • Specialist means either a physician or other health care professional who practices in a specific area other than those practiced by primary care providers, or a properly licensed, certified or registered individual health care provider whose practice is limited to rendering mental health services. For purposes of cost-share, this definition of “specialist” does not apply to dentists. BCBSAZ does not require you to obtain an authorization or referral to see a specialist.

  • Clinical nurse specialist means a registered nurse with relevant post-basic qualifications and 12 months’ experience working in the clinical area of his/her specified post-basic qualification, or a minimum of four years’ post-basic registration experience, including three years’ experience in the relevant specialist field and who satisfies the local criteria.

  • Designated chemical dependency specialist means a person

  • Specialist Physician means a licensed physician who qualifies as an attending physician and who examines a patient at the request of the attending physician or authorized nurse practitioner to aid in evaluation of disability, diagnosis, or provide temporary specialized treatment. A specialist physician may provide specialized treatment for the compensable injury or illness and give advice or an opinion regarding the treatment being rendered, or considered, for a patient’s compensable injury.

  • Substance Abuse Professional (SAP) means a qualified person who evaluates employees who have violated a DOT drug and alcohol regulation and makes recommendations concerning education, treatment, follow-up testing, and aftercare.

  • Specialist medical practitioner means a specialist as defined in section 3 of the Health Insurance Act 1973.

  • Professional land surveyor means a professional land surveyor licensed under ch. 443.

  • Participating Certified Clinical Nurse Specialist means a Certified Clinical Nurse Specialist who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Architectural Review Committee or “ARC” shall mean the architectural review committee established by the Organization to review plans submitted to the Organization for architectural review.

  • Landscape architect means a person who holds a license to practice landscape architecture in the state of California Business and Professions Code, Section 5615.

  • Trainer means a dentist whose name is included in sub-part A of the first part of the dental list who employs a trainee as an assistant in accordance with paragraph 2 of this Determination;

  • Civil engineer means a professional engineer registered in the state of California to practice in the field of civil engineering.

  • Health professional means an individual licensed or otherwise authorized to engage in a health profession under article 15 of the public health code, 1978 PA 368, MCL 333.16101 to 333.18838, and whose scope of practice includes the diagnosis and treatment of individuals with a substance use disorder.

  • Licensed Professional Engineer means a person acceptable to Buyer in its reasonable judgment who (a) is licensed to practice engineering in California, (b) has training and experience in the power industry specific to the technology of the Project, (c) has no economic relationship, association, or nexus with Seller or Buyer, other than to meet the obligations of Seller pursuant to this Agreement, (d) is not a representative of a consultant, engineer, contractor, designer or other individual involved in the development of the Project or of a manufacturer or supplier of any equipment installed at the Project, and (e) is licensed in an appropriate engineering discipline for the required certification being made.

  • Radiation safety officer means an individual who has the knowledge and responsibility to apply appropriate radiation protection regulations and has been assigned such responsibility by the licensee or registrant.

  • Genetic counselor means a person licensed by the Board to engage in the practice of genetic

  • Professional geologist means a person who is a graduate of an institution of higher education which is accredited by a regional or national accrediting agency, with a minimum of thirty semester (forty-five quarter) hours of undergraduate or graduate work in a field of geology and whose post-baccalaureate training has been in the field of geology with a specific record of an additional five years of geological experience to include no more than two years of graduate work. 23-41-208, C.R.S. and 34-1-201, C.R.S.

  • Radiation therapist means a person, other than a Licensed Practitioner or Nuclear Medicine Technologist, who applies radiation to humans for therapeutic purposes under the supervision of a Licensed Practitioner;

  • Assistant Hydrographic Surveyor means the Assistant Hydrographic Surveyor of the Authority, as the case may be

  • Design Criteria Professional means a firm who holds a current certificate of registration under Chapter 481 of the Florida Statutes, to practice architecture or landscape architecture, or a firm who holds a current certificate as a registered engineer under Chapter 471 of the Florida Statutes, to practice engineering, and who is employed by or under contract to the District to provide professional architect services, landscape architect services, or engineering services in connection with the preparation of the Design Criteria Package.

  • Assisted living services means services provided by a

  • Qard means a contract of lending money whereby the borrower is obliged to repay the equivalent amount to lender.

  • Participating Clinical Professional Counselor means a Clinical Professional Counselor who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.