Non-Participating Provider definition

Non-Participating Provider means an Administrator Hospital or Professional Provider which does not have 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 a facility which has not been designated by the Claim Administrator as a Participating Provider.
Non-Participating Provider means a Plan Hospital or Professional Pro­ vider which does not have a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide services to participants in a Participating Provider Option program or a fa­ cility which has not been designated by Blue Cross and Blue Shield of Illinois as a Participating Provider.
Non-Participating Provider means a provider that does not have a contractual relationship with an MCE and is not on their panel of providers.

Examples of Non-Participating Provider in a sentence

  • WARNING, LIMITED BENEFITS WILL BE PAID WHEN NON‐PARTICIPATING PROVIDERS ARE USED You should be aware that when you elect to utilize the services of a Non‐Partici- pating Provider for a Covered Service in non‐emergency situations, benefit payments to such Non‐Participating Provider are not based upon the amount billed.


More Definitions of Non-Participating Provider

Non-Participating Provider means a provider of medical care and/or services with which the Contractor has no Provider Agreement.
Non-Participating Provider means a Dentist who is not a Participating Provider.
Non-Participating Provider means a person, Health Care Provider, practitioner, Facility, or entity acting within their scope of practice and licensure that does not have a provider service agreement with the Contractor but provides services to Individuals. Notice of Action
Non-Participating Provider means an Administrator Hospital or Pro­ fessional Provider which does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide ser­ vices to participants in the Participating Provider Option program or a
Non-Participating Provider means a provider of medical care and/or services with which the Contractor has no Provider Agreement, as this term is defined in this Agreement.
Non-Participating Provider means those physicians, health professionals, hospitals and other facilities that have not contracted with the Plan. Non-Participating Providers are not listed in the Provider Directory. Services from a Non-Participating Provider are not Covered unless Prior Authorized by the Plan.