Specialty Physicians Sample Clauses

Specialty Physicians. You are entitled to see participating Specialty Physicians under this Empower Plan without the requirement of a referral from your PCP.
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Specialty Physicians. You are entitled to see in-network Specialty Physicians. You must have a referral from your PCP in order to see a Specialty Physician. This means that you must get approval in advance from your PCP before visiting a Specialty Physician in order for services to be covered. 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. 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.
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Specialty Physicians. You are entitled to see Specialty Physicians without the requirement of a referral from your PCP.
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Specialty Physicians. You are entitled to see participating Specialty Physicians. Under this Engage Plan, Members may need a PCP referral to see a Specialty Physician. This means you will need to get approval in advance from your PCP to see certain Specialty Physicians and to receive certain services. Referrals will be processed electronically as Physician-to-Physician transactions, meaning that your PCP will create and send the referral to the Specialty Physician electronically. This process allows PCPs to establish referrals in a manner that is faster, easier and more convenient for all.
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Specialty Physicians. You are entitled to see in-network Specialty Physicians under this Achieve Plan without the requirement of a referral from your PCP.
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Specialty Physicians. You are entitled to see participating Specialty Physicians under this Flex Plan without the requirement of a referral from your PCP.
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Specialty Physicians. You are entitled to see participating Specialty Physicians. A referral from your PCP may be required for certain types of Specialty Physicians, and Prior Authorization may be required from AvMed for certain services.
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Related to Specialty Physicians

  • Contract for Professional Services of Physicians, Optometrists, and Registered Nurses In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government Code, Section 2254.008(a)(2) is applicable to this Contract, Contractor affirms that it possesses the necessary occupational licenses and experience.

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services. This plan covers dental care for members until the last day of the month in which they turn nineteen (19). This plan covers services only if they meet all of the following requirements: • listed as a covered dental care service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered dental care service under this plan. • dentally necessary, consistent with our dental policies and related guidelines at the time the services are provided. • not listed in Exclusions section. • received while a member is enrolled in the plan. • consistent with applicable state or federal law. • services are provided by a network provider.

  • Contract for Professional Services of Physicians Optometrists, and Registered Nurses

  • Chiropractic Services This plan covers chiropractic visits up to the benefit limit shown in the Summary of Medical Benefits. The benefit limit applies to any visit for the purposes of chiropractic treatment or diagnosis.

  • Hospital Services The Hospital will: 6.1.1 achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; 6.1.2 not reduce, stop, start, expand, cease to provide or transfer the provision of Hospital Services to another hospital or to another site of the Hospital if such action would result in the Hospital being unable to achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; and 6.1.3 not restrict or refuse the provision of Hospital Services that are funded by the Funder to an individual, directly or indirectly, based on the geographic area in which the person resides in Ontario, and will establish a policy prohibiting any health care professional providing services at the Hospital, including physicians, from doing the same.