Participating providers definition

Participating providers means the providers of mental health and substance abuse services who subcontract with the contractor.

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 covered medical services who subcontract with or who are employed by the PHP.

Examples of Participating providers in a sentence

• For purposes of the provision of health care services to Beneficiaries covered by a Payor serviced under this Product, Participating Providers shall be only those physicians, practitioners and institutions that have contracted with the Payor to provide Covered Services to Beneficiaries of this Product.

• Company shall make payment of claims for Covered Services directly to Participating Providers.

• A Covered Person using a Non-Participating Provider for a PPACA Emergency shall not be liable for Co-Payments or Co-Insurance in excess of Co-Payments and Co-Insurance that would have been charged if Participating Providers had been used.

• To the extent required by PPACA, preventive care (with no cost-sharing) when preventive care is provided by Participating Providers.

• Physician will refer this Product’s Beneficiaries only to Participating Providers in this Product, except in cases of Emergency or for designated out-of-network services unless otherwise approved by Payor, as set forth in the Provider Policy and Procedure Manual.

More Definitions of Participating providers

Participating providers means the providers of covered physical health, behavioral health and long-term care services that have contracted with a managed care organization.

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 the providers of covered services who subcontract with or who are employed by the MSACP contractor.

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 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.