TRUST PRACTITIONER definition

TRUST PRACTITIONER means a physician (doctor of medicine, osteopathy, podiatry, chiropractic) or a professional provider (a doctor of medicine, osteopathy, podiatry, chiropractic, clinical licensed master social worker, fully licensed psychologist or oral surgeon) or other professional provider offered affiliation by BCBSM sometimes also referred to as "Provider" who (i) is fully licensed or legally authorized to practice in the state of Michigan, (ii) meets all of the qualifications and credentialing requirements as determined from time to time by BCBSM and (iii) has signed a BCBSM TRUST Network PRACTITIONER Affiliation Agreement.

TRUST PRACTITIONER means a person registered as a trust practitioner in terms of section 27; and

TRUST PRACTITIONER means a physician (doctor of medicine, osteopathy, podiatry, chiropractic) or a professional provider (fully licensed psychologist, oral surgeon, clinical licensed master’s social worker, licensed professional counselor, physical therapist, occupational therapist, speech therapist) or other professional provider offered affiliation by BCBSM sometimes also referred to as "Provider" who (i) is fully licensed or legally authorized to practice in the state of Michigan, (ii) meets all of the qualifications and credentialing requirements as determined from time to time by BCBSM and (iii) has signed a BCBSM TRUST Network PRACTITIONER Affiliation Agreement.

Examples of TRUST PRACTITIONER in a sentence

• If TRUST PRACTITIONER admits Members to hospitals, TRUST PRACTITIONER shall remain a member in good standing of a TRUST Hospital.

• TRUST PRACTITIONER shall submit evidence of licenses, board certifications and medical staff memberships, if applicable, to BCBSM upon request and comply with all BCBSM credentialing and recredentialing requirements.

• TRUST PRACTITIONER may be identified by BCBSM as a preferred provider in the TRUST Network.

• BCBSM or its designee shall have access to review, photocopy and audit Member's medical records and other pertinent appointment, billing and financial records of TRUST PRACTITIONER to verify medical necessity, appropriateness of payment and for fraud/abuse investigations.

• ADDENDUM A TRUST NETWORK REIMBURSEMENT POLICIES For Covered Services performed, BCBSM will pay the lesser of billed charges or the amount indicated in the BCBSM TRUST Network Fee Schedule (TRUST Fee Schedule) less any Deductible or Copayment amount for which Member is responsible, and/or less any TRUST PRACTITIONER sanction for which TRUST PRACTITIONER is responsible.

• All new providers added to group will be affiliated with BCBSM as a TRUST PRACTITIONER, if eligible for participation in that network, or as a TRADITIONAL PRACTITIONER in instances where the PROVIDER is not eligible to participate in the TRUST network.

• IF TO TRUST PRACTITIONER: Blue Cross and Blue Shield of Michigan An address current on the BCBSM TRUST PROGRAM Provider File for TRUST PRACTITIONER Professional Credentialing, MC B444 000 X.

• TRUST PRACTITIONER may participate in Quality Programs if he/she meets the standards developed by BCBSM for participation, which shall be published by BCBSM annually in the appropriate provider publication (e.g. web- DENIS, The Record).

• If not available in the TRUST Network, TRUST PRACTITIONER must refer the Member to a practitioner or health care professional or facility that participates in BCBSM's Traditional network, if available.

• ADDENDUM A TRUST NETWORK REIMBURSEMENT POLICIES For Covered Services performed, BCBSM will pay less any Deductible or Copayment amount for which Member is responsible, and/or less any TRUST PRACTITIONER sanction for which TRUST PRACTITIONER is responsible.