Common use of Specialist Clause in Contracts

Specialist. A dentist who focuses on a specific area of dentistry, including oral surgery, endodontia, periodontia, orthodontia and pediatric dentistry, or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. Spouse: The person to whom the Subscriber is legally married, including a same sex Spouse. Spouse also includes a domestic partner. Subscriber: The person to whom this Contract is issued. In the case of a Contract that provides coverage for Pediatric Dental Care only, the Subscriber refers to the Responsible Adult if the Member is under 18 years of age. UCR (Usual, Customary and Reasonable): The cost of a dental service in a geographic area based on what Providers in the area usually charge for the same or similar medical service. Us, We, Our: BlueShield of Northeastern New York and anyone to whom We legally delegate performance, on Our behalf, under this Contract. Utilization Review: The review to determine whether services are or were Medically Necessary or experimental or investigational (including treatment for a rare disease or a clinical trial). You, Your: The Member.

Specialist. A dentist who focuses on a specific area of dentistry, including oral surgery, endodontia, periodontia, orthodontia and pediatric dentistry, or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. Spouse: The person to whom the Subscriber is legally married, including a same sex Spouse. Spouse also includes a domestic partner. Subscriber: The person to whom this Contract is issued. In the case of a Contract that provides coverage for Pediatric Dental Care only, the Subscriber refers to the Responsible Adult if the Member is under 18 years of age. UCR (Usual, Customary and Reasonable): The cost of a dental service in a geographic area based on what Providers in the area usually charge for the same or similar medical service. Us, We, Our: BlueCross BlueShield of Northeastern Western New York and anyone to whom We legally delegate performance, on Our behalf, under this Contract. Utilization Review: The review to determine whether services are or were Medically Necessary or experimental or investigational (including treatment for a rare disease or a clinical trial). You, Your: The Member.

Specialist. A dentist who focuses on a specific area of dentistry, including oral surgery, endodontia, periodontia, orthodontia and pediatric dentistry, or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. Spouse: The person to whom the Subscriber is legally married, including a same sex Spouse. Spouse also includes a domestic partner. Subscriber: The person to whom this Contract Policy is issued. In the case of a Contract Policy that provides coverage for Pediatric Dental Care only, the Subscriber refers to the Responsible Adult if the Member is under 18 years of age. UCR (Usual, Customary and Reasonable): The cost of a dental service in a geographic area based on what Providers in the area usually charge for the same or similar medical service. Us, We, Our: BlueShield The Guardian Life Insurance Company of Northeastern New York America and anyone to whom We legally delegate performance, on Our behalf, under this ContractPolicy. Utilization Review: The review to determine whether services are or were Medically Necessary or experimental or investigational (including treatment for a rare disease or a clinical trial). You, Your: The Member.

Specialist. A dentist who focuses on a specific area of dentistry, including oral surgery, endodontia, periodontia, orthodontia and pediatric dentistry, or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. Spouse: The person to whom the Subscriber is legally married, including a same sex Spouse. Spouse also includes a domestic partner. Subscriber: The person to whom this Contract is issued. In the case of a Contract that provides coverage for Pediatric Dental Care only, the Subscriber refers to the Responsible Adult if the Member is under 18 years of age. UCR (Usual, Customary and Reasonable): The cost of a dental service in a geographic area based on what Providers in the area usually charge for the same or similar medical service. Us, We, Our: BlueShield of Northeastern New York MVP Health Services Corp. and anyone to whom We legally delegate performance, on Our behalf, under this Contract. Utilization Review: The review to determine whether services are or were Medically Necessary or experimental or investigational (including treatment for a rare disease or a clinical trial). You, Your: The Member.

Specialist. A dentist who focuses on a specific area of dentistry, including oral surgery, endodontia, periodontia, orthodontia and pediatric dentistry, or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. Spouse: The person to whom the Subscriber is legally married, including a same sex Spouse. Spouse also includes a domestic partner. Subscriber: The person to whom this Contract Policy is issued. In the case of a Contract Policy that provides coverage for Pediatric Dental Care only, the Subscriber refers to the Responsible Adult if the Member is under 18 years of age. UCR (Usual, Customary and Reasonable): The cost of amount paid for a dental service in a geographic area based on what Providers in the area usually charge for the same or similar medical service. Us, We, Our: BlueShield The Guardian Life Insurance Company of Northeastern New York America and anyone to whom We legally delegate performance, on Our behalf, under this ContractPolicy. Utilization Review: The review to determine whether services are or were Medically Necessary or experimental or investigational (including treatment for a rare disease or a clinical trial). You, Your: The Member.