Preferred Provider Network definition
Preferred Provider Network. , “Network” or “PPO” means a network of Providers that contract with a Preferred Provider Organization to provide services to Insureds of the Company at negotiated rates.
Preferred Provider Network means a health care provider or group of providers selected by the Scheme as the preferred provider or providers to provide to the Members of the Scheme diagnosis, treatments and care in respect of one or more conditions at a prenegotiated rate;
Preferred Provider Network. A group of Network Providers that MiSalud Enrollees may access without any requirement of a Referral or Prior Authorization; provides services to MiSalud Enrollees without imposing any Co-Payments; and meets the Network requirements described in Article 9 of this Contract.
Examples of Preferred Provider Network in a sentence
Commencing January 1, 2019, for those employees in the Blue Cross/Blue Shield Preferred Provider Network (“PPN”), 81% of the actual premium shall be paid by the employer and 19% shall be paid by the employee.
More Definitions of Preferred Provider Network
Preferred Provider Network means a Hospital, clinic or Physician that has entered into an agreement to provide specific medical care at negotiated prices. The Company maintains an international network of medical Providers and facilities with which it has arranged direct billing procedures. Please refer to your Medical Identification Card to locate Preferred Providers, or access a list of Providers at ▇▇▇.▇▇▇.▇▇▇. Prescription Drugs are medications which are prescribed by a Physician and which would not be available without such prescription. Certain treatments and medications, such as vitamins, herbs, aspirin, cold remedies, medicines, Experimental and/or Investigational drugs, or medical supplies even when recommended by a Physician, do not qualify as Prescription Drugs. Professional Sports are activities in which the participants receive payment for participation. Provider means the organization or person performing or supplying treatment, services, supplies or drugs.
Preferred Provider Network means an organization responsible for maintaining and providing a network of medical providers to perform medical services for CDCR Patient-Inmates/DJJ Youth.
Preferred Provider Network means a person [, which] that is 602 not a managed care organization, but [which] that pays claims for the 603 delivery of health care services, accepts financial risk for the delivery 604 of health care services and establishes, operates or maintains an 605 arrangement or contract with providers relating to (A) the health care 606 services rendered by the providers, and (B) the amounts to be paid to 607 the providers for such services. "Preferred provider network" does not 608 include (i) a workers' compensation preferred provider organization 609 established pursuant to section 31-279-10 of the regulations of
Preferred Provider Network means a person [, which] that is not a managed care organization, but [which] that pays claims for the delivery of health care services, accepts financial risk for the delivery of health care services and establishes, operates or maintains an arrangement or contract with providers relating to (A) the health care services rendered by the providers, and (B) the amounts to be paid to the providers for such services. "Preferred provider network" does not include (i) a workers' compensation preferred provider organization established pursuant to section 31-279-10 of the regulations of Connecticut state agencies, (ii) an independent practice association or physician hospital organization whose primary function is to contract with insurers and provide services to providers, (iii) a clinical laboratory, licensed pursuant to section 19a-30, whose primary payments for any contracted or referred services are made to other licensed clinical laboratories or for associated pathology services, or (iv) a pharmacy benefits manager responsible for administering pharmacy claims whose primary function is to administer the pharmacy benefit on behalf of a health benefit plan;
Preferred Provider Network means any of the hospitals, physicians, and other health care professionals which contract with the Trustees through Blue Cross Blue Shield of Minnesota. The network of hospitals and physicians are named in a directory given to eligible persons.
Preferred Provider Network. (PPN) shall mean a network of hospitals, day care centres, nursing homes, as the case may be in select cities which have agreed to cashless packaged rates for defined procedures for insured person/s. The list of such hospitals and procedures may be provided in the website of the Insurer and the TPA for the information of the insured/s and updated from time to time.
Preferred Provider Network means [a person, which is not a managed care organization, but which pays claims for the delivery of health care services, accepts financial risk for the delivery of health care services and establishes, operates or maintains an arrangement or contract with providers relating to (A) the health care services rendered by the providers, and (B) the amounts to be paid to the providers for such services] a person who establishes, operates, maintains or is financially responsible for, in whole or in part, an arrangement in which an agreement relating to the health care services to be rendered by providers is entered into between such providers and the person, and includes any provider-sponsored arrangement or independent practice association that offers network services. "Preferred provider network" also includes a risk-bearing preferred provider network. "Preferred provider network" does not include a workers' compensation preferred provider organization established pursuant to section 31-279-10 of the regulations of Connecticut state agencies; or an independent practice association or physician hospital organization whose primary function is to contract with insurers and provide services to providers;