Non-Plan Provider definition

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.

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Non-Plan Provider means a Provider who does not have an independent contractor agreement with HPN.

Non-Plan Provider means a Provider who does not have an independent contractor agreement with the CO-OP.

Examples of Non-Plan Provider in a sentence

• You are responsible for any Non-Plan Provider Emergency Service charges that exceed payments made by HPN.

• When seeking reimbursement from HPN for expenses incurred in connection with services received from Non-Plan Providers, the Member must complete a Non-Plan Provider Claim Form and submit it to the HPN Claims Department with copies of all of the medical records, bills and/or receipts from the Provider.

• Reimbursement for Covered Services approved by HPN and provided by a Non-Plan Provider outside HPN’s Service Area shall be limited to the average payment which HPN makes to Plan Providers in HPN’s Service Area.

• Reimbursement for Covered Services provided by a Non-Plan Provider outside HPN’s Service Area to a newborn natural child or adopted child is limited to HPN’s Eligible Medical Expense for similar Covered Services provided in HPN's Service Area.

• If the Member receives a bill for Covered Services from a Non-Plan Provider, the Member may request that HPN pay the Provider directly by sending the bill, with copies of all medical records and a completed Non-Plan Provider Claim Form to the HPN Claims Department.

More Definitions of Non-Plan Provider

Non-Plan Provider or "Out-of-network Provider" means a Provider who does not have an independent contractor agreement with LIBERTY.

Non-Plan Provider or “Out-of-network Provider” means a Provider who does not have an

Non-Plan Provider means a Provider who does not have an independent contractor agreement with Form No. SHL-Ind_AOC(2015) Page 37 SHL.

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

Non-Plan Provider means a Provider that does not meet the definition of Plan Provider unless

Non-Plan Provider means a vision provider who does not have an independent contractor agreement with SHL.

Non-Plan Provider means a pharmacy or online retailer that isn’t a Plan Provider. To find out more about coverage and limitations, including the current list of Plan Providers, visit our website or call Member Services.