Payor Contract definition

Payor Contract means the contract with a Payor, pursuant to which Company furnishes administrative services or other services in support of the Coverage Agreements entered into, issued or agreed to by a Payor, which services may include access to one or more of Company’s provider networks or vendor arrangements, except those excluded by Health Plan. The term “Payor Contract” includes Company’s or other Payor’s contract with a governmental authority (also referred to herein as a “Governmental Contract”) under which Company or Payor arranges for the provision of Covered Services to Covered Persons.

Payor Contract means any contract executed by HMHP with a Payor pursuant to which HMHP Providers will provide Covered Services to Enrollees in accordance with Health Benefit Plans.

Payor Contract means any Contract whereby a Payor has engaged the Company or any of its Subsidiaries to provide, arrange for, or assume financial risk for some health care coverage, services or treatment to which such Payor's eligible individuals are entitled.

Examples of Payor Contract in a sentence

• A Company is only responsible for performing its respective obligations hereunder with respect to a particular Product, Coverage Agreement, Payor Contract, Covered Service or Covered Person.

• Each Party is prohibited from, and shall prohibit its Affiliates and Contracted Providers from, disclosing to a third party the substance of this Agreement, or any information of a confidential nature acquired from the other Party (or Affiliate or Contracted Provider thereof) during the course of this Agreement, except to agents of such Party as necessary for such Party’s performance under this Agreement, or as required by a Payor Contract or applicable Regulatory Requirements.

• If Practice does not provide an Opt Out Election for a Risk Payor Contract, any agreement between Practice and that Payor for the same Health Benefit Plans shall be superseded by HMHP’s Payor Contract, unless otherwise agreed by HMHP and the Payor.

• Practice understands, however, that participation in a Payor Contract may be limited based on the unique needs and requirements of a Payor, and, thus, Practice agrees that nothing herein guarantees Practice’s or Participating Physicians’ right to participate in any Payor Contract.

• HMHP shall provide Practice notice of each new CI Payor Contract and Risk Payor Contract.

More Definitions of Payor Contract

Payor Contract means the written agreement entered into between CDA and a Payor that identifies the terms of the arrangement under which (a) CDA will arrange for the provision of Covered Services to Covered Persons by Participating Providers; and (b) the Payor will reimburse or pay CDA and/or Participating Providers for providing such Covered Services.

Payor Contract means an agreement (or agreements), pursuant to, or under which, a Payor shall be obligated to pay the Seller for services rendered or merchandise sold to patients of the Seller from time to time;

Payor Contract means the written agreement entered into between MPP and a Payor which identifies the terms of the arrangement under which: (i) MPP will arrange for the provision of Covered Services to Covered Persons by Participating Providers; and (ii) the Payor will reimburse or pay MPP and/or Participating Providers for providing such Covered Services.

Payor Contract means a contract between a Health Care Provider and a Health Plan for reimbursement for the Health Care Provider’s treatment of the Health Plan’s members.

Payor Contract means MCNA’s contract with any Payor that governs the provision of Covered Services to Covered Persons.

Payor Contract shall have the meaning as set forth in Section 2.16(e).

Payor Contract means an agreement between PHO and a Payor pursuant to which PHO agrees on behalf of the Participating Physicians to render Covered Services to Beneficiaries through the Participating Physicians at amounts determined and established in such agreement. Unless the PHO and Manager mutually agree on a method by which Manager shall administer and be compensated for non-capitated Payor Contracts, Payor Contracts as used in this Agreement shall include only those agreements for which payment is made to the PHO on a capitation basis in which capitation is made to PHO for a broad range of medical services.