Specialty Providers definition

Specialty Providers means health care providers such as home health, hospice, mental health, physicians, pharmacists and hospitals.
Sample 1Sample 2Sample 3
Specialty Providers means specially qualified masters level behavioral health professionals who are a) certified by the Arizona Board of Behavioral Health Examiners as a Certified Independent Social Worker (CISW), Certified Professional Counselor (CPC), or Certified Marriage and Family Therapist (CMFT); and b) credentialed by the RBHA or its designee as having two years training or experience in a specialty area treating children with certain behavioral health needs or problems; and c) contracted with the RBHA or its designee and registered with AHCCCS.
Sample 1
Specialty Providers means specially qualified masters level behavioral health professionals
Sample 1Sample 2

Examples of Specialty Providers in a sentence

  • Specialty Providers and DemonstrationsSpecialty providers, and providers involved with certain demonstrations, will submit claims to a specific MAC designated by CMS.

  • Corrective Action Plans (CAPs) are required for those PPGs/ Specialty Providers with less than 90% compliance .PPGs/Specialty Providers with deficiencies or CAPs will be monitored according to L .A .

  • Care’s directly contracted PPGs/ Specialty Providers are performed as prescribed in the UM Delegation Oversight Plan as approved by the UM Committee .

  • ACT Team providers must coordinate for continuity of care between provider, member’s Behavioral Health Home, community stakeholders, and other Specialty Providers (both physical and behavioral health) involved with the member.

  • Care reserves the right to continue to delegate UM to the PPGs/ Specialty Providers if they meet L .A .

  • Overview of Provider Services Department 59 Provider Web Portal 59 Re-credentialing 60 PCP Responsibilities 60 PCP Contract Terminations 60 Specialty Providers 61 Out-of-network providers 61 Second Opinion.

  • Specialty Providers are providers that specialize in a specific service, specific disability area, or both.

  • Model of Care Training - All contracted Primary Care and key high-volume Specialty Providers who have been identified as routinely directly or indirectly facilitating and/or providing Medicare Part C or D benefits for Molina Members will be required to complete the Model of Care training and provide attestation of training completion.

  • Specialty Providers or SpecialistsFor specialists that are terminating, MFC-DC will notify enrollees in active care with the provider within 15 days of issuance of the termination or within 30 days prior to termination, of the provider’s termination with the health plan.

  • A Core Services Agency may also enter into Affiliation Agreements with mental health providers certified by the Department to provide one or more Core Services ("Sub-providers") and/or Specialty Services ("Specialty Providers").

Related to Specialty Providers

  • Third Party Providers or “TPPs” means any payment service provider that provides payment services to you or someone else that concerns the Account, for example, an AISP (described in Clause 1(c) below).

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

  • Medical provider means a medical service provider, a hospital, a medical clinic, or a vendor of medical services.

  • Emergency medical services provider means a person who has received formal training in prehospital and emergency care, and is licensed to attend any person who is ill or injured or who has a disability. Police officers, firefighters, funeral home employees and other persons serving in a dual capacity one of which meets the definition of “emergency medical services provider” are “emergency medical services providers” within the meaning of this chapter.

  • Specialty means a broad, population-based focus of study encompassing the common health-related problems of a particular group of patients and the likely co-morbidities, interventions, and responses to those problems.

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

  • SPECIALTY HOSPITAL means a hospital or the specialty unit of a general hospital that is licensed by the state. It must be designed to care for patients with injuries or special illnesses. This includes, but is not limited to, a long-term acute care unit, an acute mental health or acute short-term rehabilitation unit or hospital. Hospital does not mean: • convalescent home; • rest home; • nursing home; • home for the aged; • school and college infirmary; • residential treatment facility; • long-term care facility; • urgent care center or freestanding ambulatory surgical center; • facility providing mainly custodial, educational or rehabilitative care; or • a section of a hospital used for custodial, educational or rehabilitative care, even if accredited by the JCAHO or listed in the AHA directory.

  • Professional Provider means a Physician, Dentist, Podiatrist, Psychologist, Chiropractor, Optometrist or any Provider designated by the Claim Administrator or another Blue Cross and/or Blue Shield Plan.

  • Data Providers means pricing vendors, analytics providers, brokers, dealers, investment managers, Authorized Persons, Subcustodians, Depositories and any other Person providing Market Data to the Custodian.

  • Third Party Provider means licensors, subcontractors and suppliers of BNYM furnishing the Third Party Products.

  • Non-Participating Home Infusion Therapy Provider means a Home Infusion Therapy Provider who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Pharmacy services means the practice of pharmacy as defined in chapter 18.64 RCW and includes any drugs or devices as defined in chapter 18.64 RCW.

  • Emergency medical care provider means an individual who has been trained to provide emergency and nonemergency medical care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic, paramedic specialist or other certification levels recognized by the department before 1984 and who has been issued a certificate by the department.

  • Corporate Services Provider means Computershare Trust Company of Canada, a trust company formed under the laws of Canada, as corporate services provider to the Liquidation GP under the Corporate Services Agreement, together with any successor corporate services provider appointed from time to time;

  • Qualified medical provider means the same as that term is defined in Section 26-61a-102.

  • Specialty fertilizer means a fertilizer distributed primarily for nonfarm use.

  • Pharmacy care means medications prescribed by a licensed physician and any health-related services considered medically necessary to determine the need or effectiveness of the medications.

  • ProviderOne or “P1” means the system commonly referred to as the Medicaid Management Information System (MMIS), and is the federally approved system used by the Washington Medicaid program to pay provider claims for goods and services authorized under the State Plan. The MMIS is certified by CMS and is the primary information system used by HCA to pay for health care.

  • Emergency medical services or “EMS” means an integrated medical care delivery system to provide emergency and nonemergency medical care at the scene or during out-of-hospital patient transportation in an ambulance.

  • 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.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Participating Home Infusion Therapy Provider means a Home Infusion Therapy Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Financial Services Provider means any Lender and any other provider of financial services or products;

  • 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.

  • Non-Participating Durable Medical Equipment Provider means a Durable Medical Equipment Provider who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79