Specialty Physician definition

Specialty Physician means a physician other than an Affiliated Physician/PCP who is licensed to practice medicine and who gives medical care to a Member on the referring order of an Affiliated Physician/PCP.
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Specialty Physician means a Participating Provider who is appropriately qualified in a certain medical specialty as determined by Plan who provides Covered Services to Members within the range of such specialty, who elects to be designated as a Specialty Physician by Plan and who meets all other requirements for Specialty Physicians contained in Plan's rules and regulations, including the Plan Provider Manual, and in the Agreement between Plan and the Specialty Physician.
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Specialty Physician means any Physician licensed under Chapter 458 (Physician), 459 (osteopath), 460 (chiropractor) or 461 (podiatrist), Florida Statutes (or if outside Florida, applicable state law), other than the Member's Primary Care Physician.
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Examples of Specialty Physician in a sentence

  • This means that you must get approval in advance from your PCP before visiting a Specialty Physician in order for services to be covered.

  • Except as provided for chiropractors, dermatologists, OB/GYNs and podiatrists, if you receive Specialty Physician services without the proper referral from your PCP the services will not be covered by us, and you will be solely responsible for the cost of such services.

  • Referrals will be processed electronically as Physician-to-Physician transactions, meaning that your PCP will create and send the referral directly to the Specialty Physician electronically.

  • You must have a referral from your PCP in order to see a Specialty Physician.

  • Under this Engage Plan, you must have a referral from your PCP in order to see a Specialty Physician.

  • The Gender Dysphoria Clinical Supervision Group is comprised of the healthcare professionals who are assigned to work with a patient diagnosed with Gender Dysphoria, the contractual Regional Director of Psychiatry, the appropriate contractual Mental Health Director, the contractual Regional Medical Director, and a contractual Specialty Physician Consultant based upon identified need (Id. at 1).

  • Patient Responsibility (Disclaimer) I understand that my insurance plan may require a referral from my Primary Care Physician in order to cover the visits to a Specialty Physician.

  • Specialty Physician Services – Services of specialty Physicians and other specialty Providers are covered when they are In-Network Providers.

  • See the definition of Pre- existing Condition.)BENEFIT INFORMATIONIN-NETWORK (Based on CIGNAcontract allowance)OUT-OF-NETWORK (Based onMaximum ReimbursableCharge)Physician ServicesPrimary Care Physician (PCP) Office Visit Specialty Physician Office Visit Consultant and Referral Physician Services Note: A Copayment applies for OB/GYN visits.

  • A PCP can help you determine when you need to visit a Specialty Physician and help you find one based on your PCP’s knowledge of you and your specific healthcare needs.


More Definitions of Specialty Physician

Specialty Physician means a physician other than an Affiliated Physician who is licensed to practice medicine or osteopathy and who delivers medical or osteopathic care to a Member on the referring order of an Affiliated Physician.
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Related to Specialty Physician

  • Medical physicist means a person trained in evaluating the performance of mammography equipment and facility quality assurance programs and who meets the qualifications for a medical physicist set forth in 41.6(3)“c.”

  • 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.

  • Primary care physician means a physician who is a family

  • Licensed physician means a person licensed to practice

  • Authorized medical physicist means an individual who:

  • Qualified physician means any physician who has not been excluded under the provisions of subpart I of this part. Except as otherwise provided by regulation, a qualified physician shall be deemed to be designated or ap- proved by OWCP.

  • Resident physician means a physician enrolled in an internship, residency or fellowship.

  • Participating physician means a physician licensed in Virginia to practice medicine, who practices

  • Physician means a licensed practitioner of medical, surgical, dental, services or the healing arts including accredited Christian Science Practitioner, acting within the scope of his/her license. The treating physician cannot be the Insured, a Traveling Companion, a Family Member, or a Business Partner.

  • Treating physician means an individual who:

  • SPECIALTY HOSPITAL means a hospital or the specialty unit of a general hospital that is licensed by the state. It must be designed to care for patients with injuries or special illnesses. This includes, but is not limited to, a long-term acute care unit, an acute mental health or acute short-term rehabilitation unit or hospital. Hospital does not mean: • convalescent home; • rest home; • nursing home; • home for the aged; • school and college infirmary; • residential treatment facility; • long-term care facility; • urgent care center or freestanding ambulatory surgical center; • facility providing mainly custodial, educational or rehabilitative care; or • a section of a hospital used for custodial, educational or rehabilitative care, even if accredited by the JCAHO or listed in the AHA directory.

  • Hospital pharmacist means an Iowa-licensed pharmacist who meets the requirements for participating in a hospital practice protocol as determined by the hospital’s P&T committee.

  • Independent physician means a physician who is chosen by the resident of the assisted living facility and who has no financial interest in the assisted living facility, directly or indirectly, as an owner, officer, or employee or as an independent contractor with the residence.

  • Outpatient hospital services means preventive, diagnostic, therapeutic, observation, rehabilitation, or palliative services provided to an outpatient by or under the direction of a physician, dentist, or other practitioner by an institution that:

  • Consulting physician means a physician who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding the patient's disease.

  • Inpatient hospital services means any health care service provided to a patient who has been admitted to a hospital and is required to remain in that hospital overnight, but does not include any secure forensic mental health services;

  • Medical cannabis means the same as that term is defined in Section 26-61a-102.

  • Dentist means a registered dental practitioner whose name is included in sub-part A of the first part of the dental list;

  • Hospice patient s family" means a hospice patient's immediate family members, including a spouse, brother, sister, child, or parent, and any other relative or individual who has significant personal ties to the patient and who is designated as a member of the patient's family by mutual agreement of the patient, the relative or individual, and the patient's interdisciplinary team.

  • Attending physician means the physician who has primary

  • Specialty means a broad, population-based focus of study encompassing the common health-related problems of a particular group of patients and the likely co-morbidities, interventions, and responses to those problems.

  • medical food means a food that is intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation and is formulated to be consumed or administered enterally under the direction of a Practitioner.

  • Licensed mental health professional or "LMHP" means a physician, licensed clinical psychologist, licensed professional counselor, licensed clinical social worker, licensed substance abuse treatment practitioner, licensed marriage and family therapist, certified psychiatric clinical nurse specialist, licensed behavior analyst, or licensed psychiatric/mental health nurse practitioner.

  • Hospice means a public agency or private organization licensed pursuant to Chapter 400, Florida Statutes, to provide Hospice services. Such licensed entity must be principally engaged in providing pain relief, symptom management, and supportive services to terminally ill Members and their families.

  • Medical cannabis card means the same as that term is defined in Section 26-61a-102.

  • Hospital services means the clinical services provided by the Hospital and the operational activities that support those clinical services, that are funded in whole or in part by the Funder, and includes the type, volume, frequency and availability of Hospital Services; HSAA Indicator Technical Specifications means the document entitled “HSAA Indicator Technical Specifications” as it may be amended or replaced from time to time;