Nonparticipating provider definition
Nonparticipating provider means a person, health care provider, practitioner, facility, or entity, acting within their scope of practice, that does not have a written contract to participate in a managed health care system's provider net- work, but provides health care services to enrollees of pro- grams authorized under this chapter or other applicable law whose health care services are provided by the managed health care system.
Nonparticipating provider means a provider who is not a participating provider.
Nonparticipating provider means, with respect to the
Examples of Nonparticipating provider in a sentence
Non-participating provider is a provider (doctor, hospital, pharmacy, etc.) that does not sign a contract to participate in the Contractor’s provider network.
More Definitions of Nonparticipating provider
Nonparticipating provider means a person, health care provider, practitioner, facility, or entity acting within their scope of prac- tice and licensure that:
Nonparticipating provider means a person who provides hospital or medical care pursuant to the Oklahoma Medicaid Program but does not have a managed care health services contract or subcontract within the Oklahoma Medicaid Healthcare Options System;
Nonparticipating provider means a health care entity or health care professional not in the contractor's participating provider network.
Nonparticipating provider means a healthcare provider who has not entered into a contract with a healthcare plan for the delivery of medical services;
Nonparticipating provider means a provider who is not a preferred provider as defined in s. 627.6471 or a provider who is not an exclusive provider as defined in s. 627.6472. For purposes of covered emergency services under this section, a facility licensed under chapter 395 or an urgent care center defined in s. 395.002 is a nonparticipating provider if the facility has not contracted with an insurer to provide emergency services to its insureds at a specified rate; see
Nonparticipating provider means a provider who is not contracted with the enrollee’s health care service plan to provide services under the enrollee’s plan contract.
Nonparticipating provider. ’ means a provider who is not contracted with a health care service plan.