Hospital Providers Sample Clauses

Hospital Providers. If Provider is a hospital (including a psychiatric hospital):
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Hospital Providers. Provider shall have a sufficient number of Hospital Providers to provide Covered Services and meet the needs of Health Plan and its Members as determined by Health Plan’s Quality Improvement Program and in accordance with state and federal law. Provider shall be responsible for the Covered Services provided by Hospital Providers.
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Hospital Providers. Hospital services providers must be qualified to provide services. All services must be provided in accordance with applicable state and federal laws and regulations. Neonates who have received the maximal benefit of specialized care but are not yet ready to be discharged may be transported back to the hospital from which they originated, if appropriate (back transport). The hospital is responsible for determining if the neonate should be back transported.
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Hospital Providers. Hospital services providers must be qualified to provide services under the Medicaid program. All services must be provided in accordance with applicable state and federal laws and regulations and adhere to the requirements set forth in the CCN-P Policy and Procedure Guide.
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Hospital Providers. 100% of the Medicare allowed amount applicable to the Provider as published annually and based on valid codes recognized by CMS in effect on the date of service, less applicable Copayments, Coinsurance and Deductibles.
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Related to Hospital Providers

  • Hospital This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. Residential Treatment Facility This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. Intermediate Care Services This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.

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