Health plan provider definition

Health plan provider means an insurance company, health maintenance organization, or other entity that provides health benefits coverage under the child health plan program. The term includes a primary care case management provider network.
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Health plan provider means any company, organization or other entity that offers insurance policies to the public, employees, or associations.
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Examples of Health plan provider in a sentence

  • Health plan provider networks must have a full range of primary care and specialist physicians with reasonable numbers of each in relationship to eligible State employees.

  • Health plan provider directories are available online.Enter the complete health plan name here.

  • The USPSTF recommendations are integrated in health plan provider manuals on clinical preventive services, performance measures, and/or other publications.▪ Health plan provider manuals.

  • ThresholdsSize range (ha)No. patchesSource: Data supplied to SEWPaC on equivalent vegetation units through NVIS.

  • ProcessHealth status/outcomesAccess/availability of care Use of services/utilizationHealth plan stability/financial/cost of care Health plan provider characteristics Enrollee safety and welfare n.l Applicable Program: LTC Personnel Responsible: State staffDetailed Description of Strategy/Yielded Information: Long-term Care plan quality and performance measure reviews are performed at least annually, at dates determined by the State.

  • Washington Department of Ecology Centennial Clean Water FundFunds water quality infrastructure and projects to control non-point source pollution.Section 319Funds non-point source pollution control projects.

  • Analysis of Recorded and Forecast ExpensesMedical plan costs are influenced by a number of factors including:Benefit plan design; Health plan provider capabilities including hospital and physician networks, the level of discounts embedded in the fees negotiated with network providers, as well as disease and medical management programs;The number of enrolled employees and dependents, and their plan coverage elections (e.g. HMO or PPO plan, and individual employee vs.

  • Compared to Table A.1, we can see that re-optimised smoothing undoes much of the benefit of parallel processing.However, in a VaR-style calculation, we usually add a relatively small amount of extra pseu- dodata to the real data, and we simulate the new pesudodata with a model which should have similar smoothing characteristics to the fitted model.

  • ProcessHealth status/outcomesAccess/availability of care Use of services/utilizationHealth plan stability/financial/cost of care Health plan provider characteristics Enrollee safety and welfare n.l Applicable Program: LTCPersonnel Responsible: State staffDetailed Description of Strategy/Yielded Information: Long-term Care plan quality and performance measure reviews are performed at least annually, at dates determined by the State.

Related to Health plan provider

  • Plan Provider means a Provider which has a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered to you.

  • Non-Plan Provider means a Provider that does not meet the definition of Plan Provider unless otherwise specified in the definition of a particular Provider.

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

  • Medical provider means a medical service provider, a hospital, a medical clinic, or a vendor of medical services.

  • Training provider means an organization meeting the eligibility conditions as mentioned in Data Sheet and selected in accordance with the criteria set forth for the purpose.

  • Education service provider means an education management organization, school

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79

  • Participating provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • Health plan issuer means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the superintendent of insurance, that contracts, or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefit plan, including a sickness and accident insurance company, a health insuring corporation, a fraternal benefit society, a self-funded multiple employer welfare arrangement, or a nonfederal, government health plan. “Health plan issuer” includes a third party administrator to the extent that the benefits that such an entity is contracted to administer under a health benefit plan are subject to the insurance laws and rules of this state or subject to the jurisdiction of the superintendent. The “Health plan issuer” is also called the Administrator in this Benefit Booklet.

  • Payment Initiation Service Provider or “PISP” means an authorised third party provider which provides a service that allows that third party to pass payment instructions to us on your behalf in relation to your Account.

  • Housing Provider means, with respect to a HOME Development, Local Government, consortia approved by HUD under 24 CFR Part 92, for-profit and Non-Profit Developers, and qualified CHDOs, with demonstrated capacity to construct or rehabilitate affordable housing.

  • Data Provider means a Participant that is registered to provide information to GS1 South Africa for use through the Verified by GS1 Services.

  • energy service provider means a natural or legal person who delivers energy services or other energy efficiency improvement measures in a final customer’s facility or premises;

  • financial service provider means a person engaged in the business of providing financial services in terms of authorisation issued or registration granted by a financial sector regulator;

  • ProviderOne or “P1” means the system commonly referred to as the Medicaid Management Information System (MMIS), and is the federally approved system used by the Washington Medicaid program to pay provider claims for goods and services authorized under the State Plan. The MMIS is certified by CMS and is the primary information system used by HCA to pay for health care.

  • Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be:

  • Retiree Health Plan means an "employee welfare benefit plan" within the meaning of Section 3(1) of ERISA that provides benefits to individuals after termination of their employment, other than as required by Section 601 of ERISA.

  • Health Plans means any and all individual and family health and hospitalization insurance and/or self-insurance plans, medical reimbursement plans, prescription drug plans, dental plans and other health and/or wellness plans.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • HMO means any health maintenance organization, managed care organization, any Person doing business as a health maintenance organization or managed care organization, or any Person required to qualify or be licensed as a health maintenance organization or managed care organization under applicable federal or state law (including, without limitation, HMO Regulations).

  • Hub Provider means an entity that (i) provides Common Channel Signaling (SS7) connectivity between the networks of service providers that are not directly connected to each other; or (ii) provides third party database services such as LIDB. The SS7 messages received by Hub Providers are accepted or rejected by the Hub Provider depending on whether a contractual arrangement exists between the Hub Provider and the message originator (sender) and whether the message originator has contracted for the type of SS7 messages being submitted for transmission to the Hub Provider.

  • Medical Specialist means any medical practitioner who is vocationally registered by the Medical Council under the Health Practitioners Competence Assurance Act 2003 in one of the approved branches of medicine and who is employed in either that branch of medicine or in a similar capacity with minimal oversight.

  • Specialist Physician means a licensed physician who qualifies as an attending physician and who examines a patient at the request of the attending physician or authorized nurse practitioner to aid in evaluation of disability, diagnosis, or provide temporary specialized treatment. A specialist physician may provide specialized treatment for the compensable injury or illness and give advice or an opinion regarding the treatment being rendered, or considered, for a patient’s compensable injury.

  • Mental health services provider means an individual, licensed or unlicensed, who performs or purports to perform mental health services, including a:

  • Individual provider means an individual provider as defined

  • Network Provider means a provider of health care, or a group of providers of health care, which has entered into a written agreement with the issuer to provide benefits insured under a Medicare Select policy.