Provider Networks definition

Provider Networks means direct service agencies that are under contract with a managing entity and that together constitute a comprehensive array of emergency, acute care, residential, outpatient, recovery support, and consumer support services.
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Provider Networks means the network of participating providers from whom a Plan Member is entitled to receive health care services on an in-network basis through the Member’s Benefit Plan. Practitioner shall participate in the Provider Networks listed on Attachment B and all Benefit Plans associated with such Provider Networks
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Provider Networks means healthcare provider who has a contractual relationship with a health insurance company, which establishes standards of care, clinical protocols, and allowable charges for specific services.
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Examples of Provider Networks in a sentence

  • Current and prospective Medicare health plans submit applications, information about Provider Networks, plan benefit packages, formularies, and other information via HPMS.

  • HMO must incorporate financial and statistical data received by its delegated networks (IPAs, ANHCs, Limited Provider Networks) in its MCFS Report.

  • I understand that Evolve and the Practitioners do not participate or contract with Medicare or any insurance plans, including, but not limited to, Health Maintenance Organizations (HMOs), Point of Service Plans (POSs), Preferred Provider Organizations (PPOs) and Preferred Provider Networks (PPNs), and that all Practitioners are opted out of the Medicare program.

  • The Contractor shall not include in its Provider Contracts any provision that directly prohibits or indirectly, through incentives or other means, limits or discourages Network Providers from participating as Network or non-network Providers in any provider network other than the Contractor’s Provider Network(s).

  • The HMO must incorporate financial and statistical data of delegated networks (e.g., IPAs, ANHCs, Limited Provider Networks), if any, in its FSR Reports.

  • The Provider Directory must include only Network Providers credentialed by the HMO in accordance with Section 8.1.4.4. If the HMO contracts with limited Provider Networks, the Provider Directory must comply with the requirements of 28 T.A.C. §11.1600(b)(11), relating to the disclosure and notice of limited Provider Networks.

  • Outreach activities shall include, but are not limited to, participation in Service Provider Networks, health fairs, community events, collaboration with other providers, and the posting flyers for potential client.

  • In addition, if Claim Administrator and Employer have agreed that (a) Host Blue(s) shall make available (a) custom health care Provider Network(s) in connection with this Agreement, then the terms and conditions set forth in Claim Administrator’s Negotiated Arrangement(s) for national accounts with such Host Blue(s) shall apply.

  • The Contractor must submit reports related to Provider Networks in accordance with Section 11, Reporting Requirements, and Exhibit H, Reporting Requirements, of this Contract.

  • The group of Providers under contract with the Contractor that are not members of the Contractor’s Preferred Provider Networks.