Second Medical Opinion. A consultation with a peer requested by the beneficiary, the HCO, a Participating Physician or the INSURER to assess the appropriateness of a previous recommendation for surgery or medical treatment. SECONDARY or SPECIALTY PHYSICIAN: A physician such as a dermatologist, urologist or cardiologist, who provides professional services on a referral from a Primary Care Provider.
Appears in 3 contracts
Samples: Terms and Conditions (Triple-S Management Corp), Terms And (Triple-S Management Corp), Health Insurance Contract (Triple-S Management Corp)
Second Medical Opinion. A consultation with a peer requested by the beneficiary, the HCO, a Participating Physician or the INSURER to assess the appropriateness of a previous recommendation for surgery or medical treatment. SECONDARY or SPECIALTY PHYSICIAN: A physician such as a dermatologist, urologist or cardiologist, who provides professional services on a referral from a Primary Care ProviderProvider SUBSCRIBER: The beneficiary covered under the individual coverage of the plan or the principal beneficiary who grants eligibility to all those beneficiaries included under the family coverage.
Appears in 2 contracts
Samples: Terms and Conditions (Triple-S Management Corp), Health Insurance Contract (Triple-S Management Corp)
Second Medical Opinion. A consultation with a peer requested by the beneficiary, the HCO, a Participating Physician or the INSURER to assess the appropriateness of a previous recommendation for surgery or medical treatment. SECONDARY or SPECIALTY PHYSICIAN: A physician such as a dermatologist, urologist or cardiologist, who provides professional services on a referral from a Primary Care Provider.
Appears in 1 contract
Samples: Health Insurance Contract (Triple-S Management Corp)
Second Medical Opinion. A consultation with a peer requested by the beneficiary, the HCO, a Participating Physician or the INSURER to assess the appropriateness of a previous recommendation for surgery or medical treatment. SECONDARY or SPECIALTY PHYSICIAN: A physician such as a dermatologist, urologist or cardiologist, who provides professional services on a referral from a Primary treatment pursuant to the Medicaid Managed Care ProviderRegulations and this contract.
Appears in 1 contract