Care Professional definition
Examples of Care Professional in a sentence
Encounter – Any Health Care Service or bundle of related Covered Services provided to one Enrollee by one Health Care Professional within one time period.
Even though a Physician or other Health Care Professional has performed, prescribed or recommended a service does not mean it is Medically Necessary or that it is covered under COVERED SERVICES AND BENEFITS.
The MCO must allow an Enrollee to choose his or her Health Care Professional to the extent possible and appropriate.
Radiology Services Covered when ordered by a Health Care Professional.
Services of Other Practitioners Covered if referred by a Health Care Professional.
Laboratory Services Covered when ordered by a Health Care Professional including urine drug screens.
Diagnostic Services Covered when ordered by a Health Care Professional.
Reporting of information on clinical team members is subject to guidelines outlined by the Health Care Professional Responsibility and Reporting Enhancement Act (HCPRREA).
Attending Health Care Professional The health care professional providing care within the scope of the professional's practice and with primary responsibility for the care provided to you.
All retrospective denials of Contracted Services are to be individual medical necessity decisions made by a Health Care Professional.