Participating providers definition

Participating providers means the providers of covered medical and health services who subcontract with or who are employed by an HMO.
Participating providers means the providers of mental health and substance abuse services who subcontract with the contractor.
Participating providers means the providers of covered physical health, behavioral health and long-term care services that have contracted with a managed care organization.

Examples of Participating providers in a sentence

  • Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna Dental or its affiliates.

  • Participating providers may never balance bill because they have agreed to always accept the Medicare allowed amount as payment in full.

  • Participating providers must be eligible to participate in the Medicaid program as determined by DHHS-Office of Inspector General (DHHS-OIG).

  • Participating providers are prohibited from making a distinction in the provision of services to Medicaid beneficiaries on the grounds of being Medicaid beneficiaries.

  • Participating providers of services under the Medicaid program, i.e., physicians, dentists, hospitals, nursing facilities, pharmacies, etc., must comply with the requirements of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, and the Age of Discrimination Act of 1975.

More Definitions of Participating providers

Participating providers shall be defined as Providers who: (i) have directly, or indirectly through Company's agreements with other networks, entered into an agreement with the Company to provide the Covered Services; and (ii) are assigned from time to time by the Company to participate in the Network or any other network of Company pursuant to this Agreement.
Participating providers means those health care providers that have directly or indirectly entered into an agreement with Beech or a Beech Affiliate to provide Covered Services with regard to the Plan applicable to the Eligible Person.
Participating providers means those providers that have been approved by the department for participation in the trauma system and include, but are not limited to, designated trauma centers, designated rehabilitation facilities, and designated fee for service physicians who provide trauma care within a designated facility.
Participating providers means those hospitals, and other health care providers who have authorized Hospital to contract on their behalf with employer in accordance with the terms of this Agreement; such Participating Providers are identified in Exhibit A, attached hereto and incorporated herein.
Participating providers. Those EMS providers represented by Participant, which are bound by the terms of this Agreement, and which are listed on Schedule I.9. Participating Provider may also be the Participant.
Participating providers means those individuals or organizations which contract directly with HPSM or BHRS to provide health care services or equipment for HPSM Members.
Participating providers means providers which have agreed to participate in the Contract Administrator’s Network, and to accept Contract Administrator’s applicable pre-negotiated payment allowance for certain Covered Services as payment in full, and therefore should not bill the Plan Participants for any amount in excess of the payment allowance for such Service(s).