Primary Care Services Clause Samples
The 'Primary Care Services' clause defines the scope and nature of healthcare services that are considered primary care under the agreement. It typically outlines the types of medical services provided, such as routine check-ups, preventive care, and management of common illnesses, and may specify the qualifications of providers or the settings in which these services are delivered. By clearly delineating what constitutes primary care, this clause ensures both parties understand the services covered, reducing ambiguity and helping to manage expectations and responsibilities.
Primary Care Services. Basic, routine or general health care services of individuals with common health problems and chronic illnesses that can be managed on an outpatient basis. Primary care is provided by primary care physicians, nurse practitioners, physician assistants and other mid-level practitioners.
Primary Care Services. As required by Section 2719A of the PHSA, as added by PPACA, each Covered Person shall be entitled to designate any Participating Provider who is a Primary Care Physician and who is available to accept the Covered Person as the Primary Care Physician for that Covered Person. If the Covered Person is a child, the child's parents shall be entitled to select for the child a Primary Care Physician who specializes in pediatric care. • Office visits with your Primary Care Physician during office hours • Treatment for illness and injury • Routine physical examinations • Well-child care from birth, including immunizations and booster doses • Annual prostate screening (PSA) and digital exam for males age 40 and over, and for males considered to be at high risk who are under age 40 • Routine gynecological examinations and Pap smears for females, performed by your Primary Care Physician or a participating gynecologist. No referral to a gynecologist is required for a female to obtain covered gynecological care from a gynecologist. • Annual mammography screening for asymptomatic women age 40 and older • Breast pumps and breast feeding supplies, not including disposable items as part of women’s preventive health in accordance with PPACA. • Routine immunizations (except those required for travel work) • Annual eye examinations without a referral to a participating provider • Routine hearing screenings
Primary Care Services. Covered Services specified in Appendix A hereto and any additional services specified as Primary Care Services in the Provider Manual, as updated or amended from time to time. All Covered Services shall be provided in the amount, duration and scope set forth in the State Contract and as otherwise required under the Program.
Primary Care Services. In the case of claims submitted by physician group practices, a primary care service is identified by the HCPCS code appearing on the claim line. HCPCS codes identifying primary care services are listed in Table 5.3 of this Appendix B. In the case of claims submitted by an FQHC (type of bill = 77x) a primary care service is identified by HCPCS code appearing on the line item claim for the service. In the case of claims submitted by an RHC (type of bill = 71x) a primary care service is identified by HCPCS code appearing on the line item claim for the service. In the case of claims submitted by a CAH Method 2 (type of bill = 85x) a primary care service is identified by HCPCS code appearing on the line item claim (for revenue centers 096x, 097x, or 098x) for the service.
Primary Care Services. As required by Section 2719A of the PHSA, as added by PPACA, each Covered Person shall be entitled to designate any Participating Provider who is a Primary Care Physician and who is available to accept the Covered Person as the Primary Care Physician for that Covered Person. If the Covered Person is a child, the child's parents shall be entitled to select for the child a Primary Care Physician who specializes in pediatric care. Office visits with your Primary Care Physician during office hours Treatment for illness and injury Routine physical examinations Well-child care from birth, including immunizations and booster doses Routine gynecological examinations and Pap smears for females, performed by your Primary Care Physician or a participating gynecologist. No referral to a gynecologist is required for a female to obtain covered gynecological care from a gynecologist. Breast pumps and breast feeding supplies, not including disposable items as part of women’s preventive health in accordance with PPACA. Routine immunizations (except those required for travel work) Annual eye examinations without a referral to a participating provider Routine hearing screenings
Primary Care Services. Group Participating PCP agrees to personally provide to Blue Choice PPO Members the full range of primary care services which are Medically Necessary.
Primary Care Services. In Provider’s capacity as a Primary Care Provider, Provider shall provide all Primary Care Services to Members who have selected or been assigned to Provider as their Primary Care Provider including the following:
Primary Care Services. Practitioner shall directly provide primary care services for Members as medically indicated, shall provide or authorize the provision of ancillary and specialty referral services, and shall coordinate the authorization of hospital inpatient and outpatient services, nursing home care and other Covered Services. Practitioner agrees not to subcontract his or her duties under this Agreement without Health Plan approval.
Primary Care Services. Developer shall develop and/or partner with a third-party organization to provide same day services for primary care within the Impact Area at an existing location, PACE facility, Federally Qualified Health Center, or near the Expanded Hospital campus. Developer shall include information on the availability of and best ways to access such primary care services on its Information Website. Developer (itself or through its partner third-party organization) shall provide such services for a period of at least ten (10) years from the date such services are commenced. X
Primary Care Services. Group Participating PCP agrees to personally provide to NativeBlue Members the full range of primary care services which are Medically Necessary.