Physician Organization definition
Examples of Physician Organization in a sentence
The Physician Organization and Practice Requirements (see Appendix C).
All property of this nature which was the proprietary property of NAMM or which the Company or an affiliated Physician Organization or hospital was allowed to utilize in the Hospital's risk Business shall remain the proprietary property of NAMM.
NAMM shall, in consultation with the Company, be responsible for the selection, development of performance standards for and appraisal of a Medical Advisor who will help manage the Risk Contracts and work in close consultation with and through the medical director of any affiliated Physician Organization or PHO.
Performance of these services will be in compliance with parameters outlined in the HMO agreements between any HMO and NHN (or, in the limited cases described above, between an HMO and the applicable affiliated Physician Organization, PHO and/or Hospital).
NAMM will use its best efforts to encourage physicians, including a sufficient number of primary care physicians, to form and participate in affiliated Physician Organizations, PHOs where payments on a capitated basis will be accepted by primary care physicians and in which a sufficient number of primary care physicians are willing and able to provide leadership to the affiliated Physician Organization and PHO.
Notwithstanding the foregoing, Company may offer a higher reimbursement level (e.g., fee-for-service maximum allowable amount, capitation rate or other reimbursement methodology) or other incentive to any Participating Physician (or Physician Group or Physician Organization) who elects to participate (or elects to continue participation) in more than one of Company’s Product Networks.
Medicaid Health Plans will make payments to a Physician Organization if the PO completes the application to participate in the Initiative and signs this participation agreement on behalf of its member Practices.
NAMM will assist the Company, and provide the Company with guidance, in negotiating which services should be provided by the Hospital and which should be provided by the physicians, as they relate to payments for such services out of the Hospital and Physician Organization service fund account, as well as which prices the Company's providers will charge.
Practices (or their Physician Organization) complete an intent to participate process which is evaluated against baseline eligibility criteria and requirements by the PCMH Initiative Operations Contractor.
Once agreed to, within ninety days after the execution of the Master Agreement by NHN, the Company and NAMM, the Joint Market Strategy shall be amended in the event there is a membership change (addition or withdrawal) in which hospitals are Hospitals, or a Physician Organization or PHO becomes or ceases being affiliated with NHN, or NAMM, NHN and the Company otherwise agree.