Network Specialist definition

Network Specialist means a medical or surgical specialist who has entered into an agreement with QualChoice to make Covered Medical Services available to Enrollees.
Network Specialist means any Network Physician who is selected by Us to provide specialty Care for Members.

Examples of Network Specialist in a sentence

  • Follow-up Care related to an emergency room visit must be rendered by an In-Network PCP or In- Network Specialist.

  • Referrals are never needed to visit a Network Specialist, including behavioral health Providers.

  • Specialty ReferralsIf you have a dental emergency which requires Specialty Care, your Network Dentist will contact Cigna Dental for an expedited referral.Referrals approved by Cigna Dental cannot be retrospectively denied except for fraud or abuse; however, your Cigna Dental coverage must be in effect at the time your Network Specialist begins each procedure.

  • When we authorize specialty dental care, a Covered Person will be referred to a Network Specialist Dentist for treatment.

  • Referrals are never needed to visit a Network Specialist including behavioral health Providers.

  • But, certain services may be eligible for referral to a Network Specialist Dentist.

  • He or she will be instructed to contact the Network Specialist Dentist to schedule an appointment.

  • If there is no Network Specialist Dentist in the Covered Person's Service Area, we will refer the Covered Person to a Non- Participating Specialist of our choice.

  • The Network includes Network Specialist Dentists in: (a) endodontics; (b) oral surgery; (c) pediatric dentistry; (d) orthodontics; and(e) periodontics, located in the Covered Person's Service Area.

  • When the care of a Network Specialist Dentist is required, the Covered Person's Participating Dentist must contact us and request authorization.

Related to Network Specialist

  • Medical Specialist means any medical practitioner who is vocationally registered by the Medical Council under the Health Practitioners Competence Assurance Act 2003 in one of the approved branches of medicine and who is employed in either that branch of medicine or in a similar capacity with minimal oversight.

  • Clinical nurse specialist means a registered nurse with relevant post-basic qualifications and 12 months’ experience working in the clinical area of his/her specified post-basic qualification, or a minimum of four years’ post-basic registration experience, including three years’ experience in the relevant specialist field and who satisfies the local criteria.

  • Peer support specialist means an individual who has experienced a severe and persistent mental illness and who has successfully completed standardized training to provide peer support services through the medical assistance program or the Iowa Behavioral Health Care Plan.

  • Network pharmacy means any pharmacy that has an agreement to accept our pharmacy allowance for prescription drugs and diabetic equipment/supplies covered under this agreement. All other pharmacies are NON-NETWORK PHARMACIES. The one exception and for the purpose of specialty Prescription Drugs, only specialty pharmacies that have an agreement to accept our pharmacy allowance are network pharmacies and all others pharmacies are non-network pharmacies.

  • Specialist means either a physician or other health care professional who practices in a specific area other than those practiced by primary care providers, or a properly licensed, certified or registered individual health care provider whose practice is limited to rendering mental health services. For purposes of cost-share, this definition of “specialist” does not apply to dentists. BCBSAZ does not require you to obtain an authorization or referral to see a specialist.

  • Specialist Physician means a licensed physician who qualifies as an attending physician and who examines a patient at the request of the attending physician or authorized nurse practitioner to aid in evaluation of disability, diagnosis, or provide temporary specialized treatment. A specialist physician may provide specialized treatment for the compensable injury or illness and give advice or an opinion regarding the treatment being rendered, or considered, for a patient’s compensable injury.

  • Interoperability means the ability of a Qwest OSS Function to process seamlessly (i.e., without any manual intervention) business transactions with CLEC's OSS application, and vice versa, by means of secure exchange of transaction data models that use data fields and usage rules that can be received and processed by the other Party to achieve the intended OSS Function and related response. (See also Electronic Bonding.)

  • Network Operator means the network operator who operates the wireless network of networks to which the SIM Cards are connected.

  • Assisted living services means services provided by a

  • Housing Specialist means a specialized position dedicated to developing the full array of housing options for their program and monitoring their sustainability for the population served in accordance with the minimal housing standards policy set by the COUNTY for their program. The Housing Specialist is also responsible for assisting Participants with applications to low income housing, housing subsidies, senior housing, etc.

  • Interface means the mixture occurring in pipeline operations between adjoining batches having similar or dissimilar physical characteristics.

  • Network User means each natural or legal person having concluded a Standard Transmission Agreement with the TSO for Transmission Services in the Transmission Grid.

  • Brand Name Specification means a specification limited to one or more items by manufacturers’ names or catalogue number.

  • Hospice services means palliative and supportive care and other services provided by an interdisciplinary team under the direction of an identifiable hospice administration to terminally ill hospice patients and their families to meet the physical, nutritional, emotional, social, spiritual, and special needs experienced during the final stages of illness, dying, and bereavement, as defined in Minnesota Statutes, § 144A.75, subd. 8, and includes the set of services as determined by the Medicare program under §1861(dd) of the Social Security Act and defined in 42 CFR § 418.3.

  • Network Services means the equipment, software, and services necessary to transmit voice, data, or video.

  • Maritime cargo handling services means activities exercised by stevedore companies, including terminal operators, but not including the direct activities of dockers, when this workforce is organised independently of the stevedoring or terminal operator companies. The activities covered include the organisation and supervision of:

  • Customer Specific Training means a private Course organized on demand specifically for Customer.

  • Counseling services means services provided by qualified social workers, psychologists, guidance counselors, or other qualified personnel.

  • Seaplane means an aeroplane capable normally of taking off from and alighting solely on water;

  • Passenger Services means the Franchisee's railway passenger services as specified in any Timetable and/or Plan of the Day including those railway passenger services which the Franchisee may delegate or subcontract or otherwise secure through any other person from time to time in accordance with the Franchise Agreement;

  • Integrated Services Digital Network (ISDN means a switched network service that provides end-to-end digital connectivity for the simultaneous transmission of voice and data. Basic Rate Interface-ISDN (BRI-ISDN) provides for a digital transmission of two (2) 64 Kbps bearer channels and one (1) 16 Kbps data channel (2B+D).

  • aeroplane means a power-driven heavier-than-air aircraft, deriving its lift in flight chiefly from aerodynamic reactions on surfaces which remain fixed under given conditions of flight;

  • Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.

  • Network plan means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.

  • Online Services means Microsoft-hosted services to which Customer subscribes under this Agreement. It does not include software and services provided under separate license terms.

  • Network Area means the 50 mile radius around the local school campus the Named Insured is attending.