Network Providers definition

Network Providers means those entities and individuals who provide covered health care services or supplies to an insured or a member pursuant to a contract with a network plan to act as a participating provider.

Network Providers or “Contracted Provider” or “Provider” shall mean the pool of contracted behavioral health professionals, substance abuse professionals, or Employee Assistance Professionals who have been approved by DES as a result of an RFQ.

Network Providers means those pharmacies that provide covered health care services or supplies to an insured or a member pursuant to a contract with a network plan to act as a participating provider;

Examples of Network Providers in a sentence

• For Network Providers and Out-of Network providers with written reimbursement arrangements with the MCO, the MCO must pay the unpaid balance for Covered Services up to the agreed rates.

• Payment to Out-of-Network providers must be made within the time period required for Network Providers.

• Medicaid HMOs must contract with physicians who are not Network Providers to resolve claims disputes related to denial on the basis of medical necessity that remain unresolved subsequent to a Provider appeal.

• The HMO must keep participating physicians and other Network Providers informed about the QAPI Program and related activities.

• The HMO must prepare and issue a Provider Manual(s), including any necessary specialty manuals (e.g., behavioral health) to all existing Network Providers.

More Definitions of Network Providers

Network Providers means health care professionals, including but not limited to, primary care physicians, specialists, ancillary providers, hospitals, clinics, pharmacies, rehabilitation facilities and other inpatient and outpatient health care facilities that have directly or indirectly contracted to participate in a Network, and which are duly licensed and/or certified as required by applicable law.

Network Providers means a provider of health care, or a group of providers of health care, which has entered into a written agreement with the issuer to provide benefits insured under a Medicare Select policy.

Network Providers means the providers of debit transaction network services under the Program mutually agreed upon by Retailer and Bank after requesting and reviewing *** Confidential material redacted and filed separately with the Commission the service proposals and subject to change upon the mutual agreement of Bank and Retailer, and which shall include, as of the Commencement Date, Visa and Interlink.

Network Providers means those pharmacists and pharmacies who provide covered health-care

Network Providers means those entities and individuals who provide covered health care services or supplies to an insured or a

Network Providers are providers that have agreed to participate in the Blue Network, and to accept BlueCross’s applicable pre-negotiated payment allowance for certain Covered Services as payment in full, and therefore should not bill the Members for any amount in excess of the payment allowance for such service(s). The pre-negotiated payment will be based upon charges for Covered Services or upon an alternative method of payment, including per diem amounts, percent of charges, global case rate and fee schedule arrangements, and may be further reduced by other contractual reductions, adjustments, discounts or offsets based on BlueCross’s agreements with Network Providers. Network Providers will file Members’ claims with BlueCross, and BlueCross will make payment directly to Network Providers.

Network Providers means those entities and individuals who provide covered health care services and supplies to covered persons pursuant to a contract with a managed care plan to act as a participating provider.