POS PLAN definition
POS PLAN means a Product that allows its Members to self-refer to MHSA Providers or non-MHSA Providers without the necessity of a referral from PBHC.
POS PLAN means a point-of-service Health Plan under which a Subscriber can choose, at the time Subscriber seeks covered non-Emergency Care, whether to obtain In-Network Services or Out-of-Network Services. Preauthorization means BCBSTX’s prior approval of certain services provided to Subscribers under the terms of their Benefit Document as being Covered Services. Primary Care Physician means a Participating physician who has agreed to be responsible for providing basic health services, coordinating the care of individual Subscribers, and referring those Subscribers to other Participating Providers. This concept generally applies to Subscribers who have POS coverage.
POS PLAN means a Health Plan that requires the designation of a Primary Care Physician (PCP) who must coordinate all Covered Services, including Proper Referrals to Specialists and Preauthorizations when required, in order for the Subscriber to receive the highest level of benefits under the Health Plan.