Represented Provider definition

Represented Provider means a licensed physician or other licensed provider (a) that is associated with or otherwise represented by CONTRACTING PROVIDER; (b) that is authorized by CONTRACTING PROVIDER to provide services pursuant to this Agreement; (c) that has completed a Credentialing Application, if required by Anthem BC&BS; (d) that has agreed with CONTRACTING PROVIDER to be subject to the requirements of this Agreement to the extent applicable to Represented Provider and (e) that is accepted by Anthem BC&BS as a Participating Provider.
Sample 1
Represented Provider means a licensed ophthalmologist, optometrist or optician (a) who is employed by, associated with or otherwise represented by the Group; (b) who is authorized by the Group to provide services pursuant to this Agreement; (c) who has completed a HealthCare Professional Credentialing Application; and (d) who has agreed with the Group to be subject to the requirements of this Agreement to the extent applicable to the Represented Provider.
Sample 1

Examples of Represented Provider in a sentence

  • The Provider Credentialing Applications submitted by or on behalf of each Represented Provider are expressly incorporated by reference into this Agreement.

  • Anthem BC&BS may require CONTRACTING PROVIDER to terminate or suspend the participation of any Represented Provider for cause, such termination or suspension to be effective immediately upon notice to CONTRACTING PROVIDER, unless Anthem BC&BS specifies a later date or unless otherwise provided by applicable law.

  • As SRV recommends an assessment as to capacity is undertaken at the time all instruments are created, measures to assess subsequent loss of capacity must be outlined in the instrument itself.

  • Anthem BC&BS reserves the right to transfer, if feasible and medically appropriate, those Members being treated by Represented Provider to another Participating Provider once notice of the termination of this Agreement is provided.

  • CONTRACTING PROVIDER and each Represented Provider shall maintain general and professional liability coverage in a form and amount acceptable to BC&BS.

  • Group and its Represented Providers shall not charge a Participant for a service that is not Medically Necessary unless, in advance of providing the service, Group or its Represented Provider has notified the Participant that the particular service will not be covered and the Participant acknowledges in writing that he or she will be responsible for payment for such service.

  • Trade and other receivables mainly comprise contractual amounts due from housing associations and land sales to other quoted housebuilders.

  • In order to become a Represented Provider, each provider may be required to submit to Anthem BC&BS a Credentialing Application.

  • I’ve worked with my peers on implementing similar strategies, while adjusting the strategies to be more suitable for their specific classroom and teaching style.Moving forward, I plan to encourage educators to research various engagement strategies they would be interested in implementing in their classroom.

  • Delegate shall credential each Represented Provider in accordance with the requirements set forth herein and shall recredential each initially credentialed Represented Provider in accordance with such requirements at least 1) every three years or 2) as often as is mandated by applicable state or federal law, whichever is more frequent.

Related to Represented Provider

  • Designated provider means a person who:

  • Affiliated provider means a health professional, licensed hospital, licensed pharmacy, or any other institution, organization, or person that has entered into a participating provider contract, directly or indirectly, with a health maintenance organization to render 1 or more health services to an enrollee. Affiliated provider includes a person described in this subdivision that has entered into a written arrangement with another person, including, but not limited to, a physician hospital organization or physician organization, that contracts directly with a health maintenance organization.

  • Approved provider means a provider of services registered with the appropriate association or organization to render services to a member and approved by Latrobe to render services to its members.

  • Qualified provider means a person or business experienced in the design, implementation, and installation of energy conservation measures. A qualified provider to whom the contract is awarded shall give a sufficient bond to the school district for its faithful performance.

  • Registered Provider means a registered provider of social housing (see section 80 of the Housing and Regeneration Act 2008);

  • Preferred Provider or “Network Provider” means a doctor, hospital, medical facility or other provider of health care which is included in a network which has been designated by the Fund to render health related services to Fund participants.

  • Recognised Provider (Approved Provider) means a provider of services registered with the appropriate association or organization to render services to a member and approved Latrobe to render services to its members.

  • Related provider trust means a titling trust or other trust established by a licensed viatical settlement provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. The trust shall have a written agreement with the licensed viatical settlement provider under which the licensed viatical settlement provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files related to viatical settlement transactions available to the commissioner as if those records and files were maintained directly by the licensed viatical settlement provider.

  • incorporated provision has the meaning specified in Section 107.

  • Represented person means the principal, beneficiary, partnership, corporation, or other person to whom the duty stated in subdivision (a) is owned.

  • New Provider means any replacement service provider or providers engaged to provide the Services (or part thereof) or substantially similar services or the Authority itself where the Services or substantially similar services or part thereof continue to be provided by the Authority after partial termination, termination or expiry of this Contract;

  • Preferred Provider Organization or "PPO" means an entity through which a group of health care providers, such as doctors, hospitals and others, agree to provide specific medical and hospital care and some related services at a negotiated price.

  • Warranted Person means a person who is Warranted or who is employed by a person who is Warranted; and

  • Hub Provider means an entity that (i) provides Common Channel Signaling (SS7) connectivity between the networks of service providers that are not directly connected to each other; or (ii) provides third party database services such as LIDB. The SS7 messages received by Hub Providers are accepted or rejected by the Hub Provider depending on whether a contractual arrangement exists between the Hub Provider and the message originator (sender) and whether the message originator has contracted for the type of SS7 messages being submitted for transmission to the Hub Provider.

  • Contracted Processor means a Subprocessor;

  • Participating provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • the sub-processor means any processor engaged by the data importer or by any other sub-processor of the data importer who agrees to receive from the data importer or from any other sub-processor of the data importer personal data exclusively intended for processing activities to be carried out on behalf of the data exporter after the transfer in accordance with his instructions, the terms of the Clauses and the terms of the written subcontract;

  • Replacement Provider has the meaning set forth in Section II.D.1.

  • the subprocessor means any processor engaged by the data importer or by any other subprocessor of the data importer who agrees to receive from the data importer or from any other subprocessor of the data importer personal data exclusively intended for processing activities to be carried out on behalf of the data exporter after the transfer in accordance with his instructions, the terms of the Clauses and the terms of the written subcontract;

  • Conflict of Interest means that because of other activities or relationships with other persons, a person is unable or potentially unable to render impartial assistance or advice to the State, or the person's objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage.

  • DFS means Deutsche Financial Services Corporation, a Nevada corporation, or its successors in interest.

  • Nonparticipating provider means a person, health care provider, practitioner, facility, or entity, acting within their scope of practice, that does not have a written contract to participate in a managed health care system's provider net- work, but provides health care services to enrollees of pro- grams authorized under this chapter or other applicable law whose health care services are provided by the managed health care system.

  • 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.

  • Non-Participating Provider means a Plan Hospital or Professional Pro­ vider which does not have a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide services to participants in a Participating Provider Option program or a fa­ cility which has not been designated by Blue Cross and Blue Shield of Illinois as a Participating Provider.

  • Organizational Conflict of Interest means that because of other activities or relationships with other persons, a person is unable or potentially unable to render impartial assistance or advice to the Government, or the person's objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage. "Person" as used herein includes Corporations, Partnerships, Joint Ventures, and other business enterprises.

  • Training provider means an organization meeting the eligibility conditions as mentioned in Data Sheet and selected in accordance with the criteria set forth for the purpose.