Member Provider definition

Member Provider means an optometrist or ophthalmologist who has entered into an agreement with AEA or APEC to provide the services and benefits described above to participants in the Trust.
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Member Provider means any physician; physician group; hospital; surgery ---------------- center; diagnostic imaging center; laboratory; clinic; chiropractor; dentist; podiatrist; psychologist; social worker; physical, occupational and speech therapist; etc. licensed or certified to practice a healthcare profession or licensed as a facility to offer healthcare services, in the state where services are rendered, who has met the credentialing requirements of RHG, and who has been accepted by RHG as a Member Provider and who has executed a contract with RHG.
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Member Provider means any physician; (c) in the case of a mental health condition, one that physician group;hospital; surgery center; diagnostic could reasonably present danger to the person imaging center, laboratory; clinic; chiropractor; experiencing the mental health Condition or another dentist; podiatrist; psychologist; social ,vorker; person as defined in T1C 1305.004
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Examples of Member Provider in a sentence

  • MediaNet shall permit Member Provider or its designees reasonable access during normal business hours and, upon request, to verify funds and payments due pursuant to this Agreement.

  • If a MCO has a single hotline serving multiple Service Areas, multiple MCO Programs, or multiple hotline functions, (i.e. Member, Provider, Behavioral Health Services hotlines), HHSC may request on an annual basis that the MCO submit certain hotline response information by MCO Program, Service Area, and hotline function, as applicable to the MCO.

  • If Provider concludes that care recommended or authorized through the utilization management program is medically inappropriate for the Member, Provider may access the expedited appeal process as described in the Provider Manual.

  • In the event a Member seeks and obtains a recovery from a third party or a third party’s insurer for injuries caused to that Member, Provider shall have no right to assert or pursue a third party lien for any Covered Services provided to that Member.

  • In the event of an Inpatient admission, either the Member, Provider, or a family member must notify the Plan within forty-eight (48) hours of the admission, or as soon as reasonably possible.

  • USA will act as a mediator between Member Provider and INSURER to resolve the dispute.

  • Member Provider may, for a period of 90 (ninety) days from the receipt of payment of a claim, review the payment and provide to INSURER written notice of any perceived underpayment.

  • Member Provider agrees to cooperate with USA acting as mediator, and INSURER in resolving the dispute.

  • USA agrees to attempt resolution of any dispute that may arise between Member Provider and INSURER from services delivered by Member Provider to an INSURED of INSURER.

  • Upon receipt of notification of ineligibility of a Medicare Member, Provider shall use reasonable efforts (i) to advise such Medicare Member of alternative health care providers, programs or arrangements, if any, available to such Medicare Member; and (ii) to assist in the transfer of such Medicare Member whose responsibility for treatment is assumed by another health care provider.