Network Practitioner definition

Network Practitioner means a practitioner who has entered into an agreement with OptumHealth as an independent contractor to provide covered services to you. The records of OptumHealth shall be conclusive as to whether a person had a network provider agreement in effect on the date that you obtained services. A non-network practitioner can be considered a network practitioner on a case-by-case basis when approved by OptumHealth.
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Network Practitioner means a practitioner who has entered into an agreement with ValueOptions as an independent contractor to provide covered services to you. The records of ValueOptions shall be conclusive as to whether a person had a network provider agreement in effect on the date that you obtained services. A non-network practitioner can be considered a network practitioner on a case-by-case basis when approved by ValueOptions.
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Network Practitioner means a licensed practitioner of the healing arts, dentistry or recognized dental specialty who has entered into this Contract with EGID to accept scheduled reimbursement for covered Medical or Dental Services provided to Members.
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Examples of Network Practitioner in a sentence

  • If such [Network] Practitioner(s) believe(s) that the recommended procedures, medicines, or courses of treatment are Medically Necessary and Appropriate, the [Network] Practitioner shall inform the [Member] of the consequences of not complying with the recommended procedures, medicines, or courses of treatment and seek to resolve the disagreement with the [Member] and or the [Member's] family or other person acting on the [Member's] behalf.

  • Further, a [Member] may, for personal, religious or cultural reasons disagree or not comply with procedures, medicines, or courses of treatment deemed Medically Necessary and Appropriate by a [Network] Practitioner.

  • A [Member] who refuses procedures, medicines or courses of treatment has the right to seek a second opinion from another [Network] Practitioner.

  • In such event, We will continue to provide all benefits covered by this Contract for 30 days or until the date of termination, whichever comes first, and We and the [Network] Practitioner will cooperate with the [Member] in facilitating a transfer of care.

  • DISORDER (TMJ) The following services are covered when rendered by a [Network] Practitioner [upon prior Referral by a [Member's] Primary Care Provider].

  • Dental benefits available to all [Members] The following services are covered for all [Members] when rendered by a [Network] Practitioner [upon prior Referral by a [Member's] Primary Care Provider].

  • The following services are covered when rendered by a [Network] Practitioner [upon prior Referral by a [Member's] Primary Care Physician].

  • Upon receipt of such a claim We will compare the coverage for the orally-administered anti-cancer prescription drugs as covered under the Prescription Drugs provision to the coverage the Contract would have provided if the [Member] had received intravenously administered or injected anti cancer medications from the Network Practitioner to determine which is more favorable to the [Member] in terms of copayment, deductible and/or coinsurance.

  • DISORDER (TMJ) The following services are covered when rendered by a [Network] Practitioner [upon prior Referral by a [Member's] Primary Care Physician].

  • If a Network Practitioner provides Medically Necessary and Appropriate services through Telehealth and/or Telemedicine that are consistent with the requirements of P.L. 2017, c.

Related to Network Practitioner

  • Health practitioner means a registered health practitioner registered or licensed as a health practitioner under an appropriate law of the State of Tasmania.

  • Sole practitioner means an individual incorporated under the laws of the state of Iowa, or an individual in private practice who is providing substance abuse treatment services independent from a program that is required to be licensed in accordance with Iowa Code section 125.13(1).

  • Practitioner means a physician, dentist, licensed nurse practitioner pursuant to § 54.1-2957.01,

  • Health care practitioner means an individual licensed

  • Licensed practitioner means an individual who has been trained in the use of personal restraint and seclusion, who is knowledgeable of the risks inherent in the implementation of personal restraint and seclusion, and who is 1 of the following:

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Nurse practitioner means an advanced practice registered nurse who is jointly licensed by the

  • Respiratory care practitioner means a person who is

  • Chinese Medicine Practitioner means a Chinese medicine practitioner who is duly registered with the Chinese Medicine Council of Hong Kong pursuant to the Chinese Medicine Ordinance (Cap. 549) of the laws of Hong Kong, but excluding the Insured Person, the Policyholder, an insurance intermediary, an employer, employee, Immediate Family Member or business partner of the Policyholder and/or Insured Person.

  • Registered Health Practitioner means a health practitioner registered, or licensed, as a health practitioner (or as a health practitioner of a particular type) under a law of a State or Territory that provides for the registration or licensing of health practitioners (or health practitioners of that type).

  • Specialist medical practitioner means a specialist as defined in section 3 of the Health Insurance Act 1973.

  • goods and services tax practitioner means any person who has been approved under section 48 to act as such practitioner;

  • medical practitioner means a person who holds a valid registration from the Medical Council of any State or Medical Council of India or Council for Indian Medicine or for Homeopathy set up by the Government of India or a State Government and is thereby entitled to practice medicine within its jurisdiction; and is acting within its scope and jurisdiction of license. The registered practitioner should not be the insured or close Family members.

  • Licensed Independent Practitioner means any individual permitted by law and by the Medical Staff and Board to provide care and services without direction or supervision, within the scope of the individual’s license and consistent with individually granted clinical privileges.

  • legal practitioner means an advocate, vakil or an attorney of any High Court, and includes a pleader in practice.

  • general medical practitioner means a general practitioner as defined in section 3 of the Health Insurance Act 1973.

  • Cosmetologist means an individual licensed under this chapter to practice cosmetology.

  • Certified nurse practitioner means an ARNP educated in the disciplines of nursing who has advanced knowledge of nursing, physical and psychosocial assessment, appropriate interventions, and management of health care, and who possesses evidence of current certification by a national professional nursing association approved by the board.

  • Qualified Medical Practitioner means any person legally authorized by the Government with jurisdiction in the geographical area of his or her practice to render medical or surgical service, but excluding a qualified medical practitioner who is the Insured Person or an Immediate Family Member of the Insured Person.

  • general practitioner means a medical practitioner engaged in the provision of primary, continuing whole-patient care to individuals, families and their community not being a vocationally registered general practitioner.

  • Mid-level practitioner means a certified nurse-midwife engaging in the independent practice of midwifery under the independent practice of midwifery act, an advanced practice registered nurse issued a license pursuant to K.S.A. 65-1131, and amendments thereto, who has authority to prescribe drugs pursuant to a written protocol with a responsible physician under K.S.A. 65-1130, and amendments thereto, or a physician assistant licensed under the physician assistant licensure act who has authority to prescribe drugs pursuant to a written agreement with a supervising physician under K.S.A. 65-28a08, and amendments thereto.

  • registered medical practitioner means a medical practitioner registered under the Medical Act 1971 [Act 50];

  • Dental practitioner means a person in private practice registered by the Australian Dental Association.

  • Health profession ’ means allopathic medicine, family medicine, internal medicine, pediatrics, geriatric medicine, obstetrics and gynecology, podiatric medicine, nursing, public health nursing, dentistry, psychiatry, osteopathy, optometry, pharmacy, psychology, public health, social work, marriage and family therapy, chiropractic medicine, environmental health and engineering, and allied health profession, or any other health profession.

  • School nurse means a registered professional nurse with Maine Department of Education certification for school nursing.

  • Impaired practitioner means individuals whose professional practice is adversely affected by substance abuse, addiction, or other health-related conditions.