Commercial health plan definition

Commercial health plan means a plan offered by any third party payor that negotiates
Commercial health plan means a plan offered by any third party payor that negotiates with a party to a cooperative agreement with respect to patient care services rendered by health care providers.
Commercial health plan means a health insurance product licensed to do business by the State of Texas Department of Insurance. This includes, but is not limited to, Health Maintenance Organizations, Preferred Provider Organizations, Exclusive Provider Organizations, Employer SponsoredSelf-Insurance Plans, Point of Service Plans, and standard indemnity health insurance plans.

Examples of Commercial health plan in a sentence

  • Commercial health plan coverage of selected treatments for opioid use disorders from 2003 to 2014.

  • Commercial health plan to issue their own letter with their physician signature.

  • Commercial health plan premium rates are established based on anticipated benefit costs.

  • Commercial health plan representative – AHIP and BCBSA will name another representative.

  • Commercial health plan provider networks in Rockford typically include only two of the three hospitals in Rockford.

  • These data can include the following:▪ Medicaid health plan performance averages, nationally and in the state▪ Individual Medicaid health plan performance metrics▪ Commercial health plan averages in the state▪ Oral health care utilization, quality, and timeliness benchmarks set by state or federal authorities▪ Other data, such as regional or public health reports, that reinforce the importance of the identified topic and/or provide some comparison or benchmark for each health plan’s aims and progress.

  • KYBCBS-CM-004098-22 URL: https://providernews.anthem.com/kentucky/article/reminder-use-availity-to-submit-medical-records Update to formulary lists for Commercial health plan pharmacy benefitPublished: Sep 1, 2022 - Products & Programs / Pharmacy Effective with dates of service on and after October 1, 2022, and in accordance with the IngenioRx* Pharmacy and Therapeutics (P&T) process, Anthem Blue Cross and Blue Shield will update its drug lists that support Commercial health plans.

  • APPENDIX A MEASURE-SPECIFIC DETAIL ON MEDICAID AND COMMERCIAL HEALTH PLAN BENCHMARKS This page left blank for double-sided copying.MEASURE-SPECIFIC TABLES FVA-1 Commercial health plan performance, HEDIS 2013: Flu shots for adults ages 50 to 64 A.7FVA-2 Commercial health plan change in performance, HEDIS 2011–2013: Flu shots for adultsages 50 to 64 ................................................................................................................................

  • About 70% are enrolled in Intermountain’s SelectHealth Commercial health plan, usually reflecting a child with a parent who applied for family coverage through an employer.

  • Commercial health plan enrollments for fully insured health plans in 2007 totaled 168.2 million enrollees.53 In the 1990s, proponents of “consumer-directed” health care proposed measures intended to make consumers more sensitive to medical care costs.

Related to Commercial health plan

  • Health plan or "health benefit plan" means any policy,

  • Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.

  • Licensed mental health professional or "LMHP" means a physician, licensed clinical psychologist, licensed professional counselor, licensed clinical social worker, licensed substance abuse treatment practitioner, licensed marriage and family therapist, certified psychiatric clinical nurse specialist, licensed behavior analyst, or licensed psychiatric/mental health nurse practitioner.

  • Community mental health program means all mental health

  • Commercial Service means service to Customers engaged primarily in the sale of goods or services including institutions and local, sate and federal government agencies for uses other than those involving manufacturing or electric power generation.

  • Home health aide means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.

  • Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.

  • Designated mental health professional means a mental health

  • Health planning region means a contiguous geographical area of the Commonwealth with a

  • Mental health professional means a psychiatrist,

  • Mental health facility means a mental health facility as defined by the Inpatient Mental Health Treatment of Children Act;

  • Behavioral health means the promotion of mental health, resilience and wellbeing; the treatment of mental and substance use disorders; and the support of those who experience and/or are in recovery from these conditions, along with their families and communities.

  • Qualified mental health professional means a licensed medical practitioner or any other person meeting the qualifications specified in OAR 309-019-0125.