Provider types definition

Provider types means the characteristics of child care providers, which determine their approved reimbursement rate, capacity, staffing levels etc. as follows:
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Examples of Provider types in a sentence

  • Provider types that require Medicare and/or national certification, as defined in Federal regulations, must have the required certifications.

  • The practice, agency, or individual provider, as applicable, renders services utilizing one of the following Medicaid Provider types: 9.2.1.5.1. Physician (Code 05).

  • IEHP does not require Delegated IPAs to contract with the following Provider types.

  • The Provider types and specialty codes are as follows: ▪ General – PT 03, SC 030 ▪ County – PT 03, SC 031 ▪ Hospital-based – PT 03, SC 382 ▪ Certified Rehab Agency – PT 03, SC 040 OMAP Hotlines — Department phone lines designed to address and facilitate resolution of issues encountered by Recipients and their advocates or Providers according to PH-MCO policies and procedures.

  • IEHP does not require Delegated IPAs to contract with the following Provider types, where services rendered by these Practitioners are covered by IEHP, however, must utilize the network contracted by IEHP.

  • If Delegate policies and procedures address all Provider types, the Delegate will not need to specify which types they do not contract with.

  • Provider types that can serve as dental homes are federally qualified health centers and individuals who are general dentists or pediatric dentists.

  • The Provider types and specialty codes are as follows:  General – PT 03, SC 030  County – PT 03, SC 031  Hospital-based – PT 03, SC 382  Certified Rehab Agency – PT 03, SC 040 OMAP Hotlines — The PH-MCO will cooperate with the functions of OMAP’s Hotlines, which are designed to address clinically-related systems issues encountered by Recipients and their advocates or Providers.

  • The Division may also request Provider termination work plans and supporting documentation for other Provider types.

  • In instances where IEHP does not meet time and distance standards for specific Provider types in IEHP’s service region, IEHP will allow Members to see a Provider who is not currently in IEHP’s contracted network.

Related to Provider types

  • Provider Agreements means all participation, provider and reimbursement agreements or arrangements now or hereafter in effect for the benefit of Tenant or any Manager in connection with the operation of any Facility relating to any right of payment or other claim arising out of or in connection with Tenant’s participation in any Third Party Payor Program.

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

  • Provider agreement means the signed, written, contractual agreement between the department and the provider of services or goods.

  • Provider Service means a Provider’s hosted online services (if any) as described in the Solution Exhibit which is provided by Provider to Customers located in the Territory through remote access via the Internet as part of the BPO Service. A Provider Platform Application shall be considered a Provider Service.

  • Provider panel means those providers with which a carrier contracts to provide health care services

  • Medicaid Provider Agreement means an agreement entered into between a state agency or other such entity administering the Medicaid program and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicaid patients in accordance with the terms of the agreement and Medicaid Regulations.

  • Provider Manual means a working document, including but not limited to BCBSM published bulletins and provider notices, that provide specific guidelines and direction by which providers may meet their contractual responsibility as described in this Agreement. Provider Manuals are published on web-DENIS.

  • Provider Personnel means all persons employed or engaged by the Provider together with the Provider’s servants, agents, consultants and Sub-Contractors (and all persons employed by any Sub-Contractor together with the Sub-Contractor’s servants, consultants, agents, Provider’s and Sub-Contractors) used in the performance of its obligations under this Agreement;

  • Provider contract means any contract between a provider and a carrier (or a carrier's network,

  • Enhanced Service Provider (ESP means the provider of enhanced services, as those services are defined in 47 CFR Section 64.702.

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • Provider agency means a funded organization under contract with the Children’s Board to deliver and provide social services and supports to children and families of Hillsborough County, FL.

  • Medicare Provider Agreement means an agreement entered into between CMS or other such entity administering the Medicare program on behalf of CMS, and a health care provider or supplier under which the health care provider or supplier agrees to provide items and services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Provider fee means the consideration paid for a service contract.

  • Local Service Provider (LSP means the LEC that provides retail local Exchange Service to an End User. The LSP may or may not provide any physical network components to support the provision of that End User’s service.

  • Providers means individuals or organizations --------- licensed to practice dentistry (including specialists) as well as other dental professionals who provide ancillary reimbursable dental services.

  • Provider Number means an identifying number issued to each homecare worker who is enrolled as a provider through the Department.

  • Internet Service Provider (ISP) means an Enhanced Service Provider (ESP) that provides Internet Services.

  • Service Animal means an animal that is required by a person with a disability for assistance and is certified, in writing, as having been trained by a professional service animal institution to assist a person with a disability and which is properly harnessed in accordance with standards established by a professional service animal institution.

  • Provider Organization means a group practice, facility, or organization that is:

  • Service Provider Personnel means and refers to Service Provider employees or subcontractors hired and maintained to perform Services hereunder.

  • Provider is any individual or company that provides professional or technical services.

  • Provider Enrollment means an agreement between the Department and a Medicaid provider to provide room and board and deliver care and services to a Medicaid eligible individual in an adult foster home for compensation.

  • Service Provider Materials means all works of authorship, products and materials [including, but not limited to, data, diagrams, charts, reports, specifications, studies, inventions, software, software development tools, methodologies, ideas, methods, processes, concepts and techniques] owned by, or licensed to, the Service Provider prior to the Commencement Date or independently developed by the Service Provider outside the scope of this Agreement at no expense to Transnet, and used by the Service Provider in the performance of the Services;

  • Provider Platform Application means an application or a set of related functionality deployed on a Platform Cloud Service, created by Provider using the Tools to run on or with the Platform Cloud Service for access by End Users.

  • Provider of health care means a physician or physician assistant licensed pursuant to chapter 630, 630A or 633 of NRS, perfusionist, dentist, licensed nurse, dispensing optician, optometrist, practitioner of respiratory care, registered physical therapist, podiatric physician, licensed psychologist, licensed audiologist, licensed speech-language pathologist, licensed hearing aid specialist, licensed marriage and family therapist, licensed clinical professional counselor, chiropractor, licensed dietitian or doctor of Oriental medicine in any form.