Participating Practitioner definition

Participating Practitioner means an individual health care practitioner who is licensed under the laws of the State in which the individual is providing Health Care Services and has a direct or indirect contractual arrangement with OhioHealthy to provide Covered Services to Beneficiaries. Participating Provider means a hospital, ambulatory care facility, home health care agency or any other organization, including a group or network of Participating Practitioners that provides Health Care Services and has a direct or indirect contractual arrangement with OhioHealthy to provide Covered Services to Beneficiaries. Payor means any employer, trust, insurance company, union health and welfare fund, preferred provider organization, health maintenance organization, health insuring corporation, intermediary organization, or any other person or entity that has entered into a Service Agreement with OhioHealthy . Performance Improvement Plan means the plan developed in conjunction with a Participating Provider or Participating Practitioner prior to termination of the Participating Provider or Participating Practitioner for failure to meet OhioHealthy’s Quality Management and/or Utilization Management standards. Program means a Preferred Provider Organization (PPO) or other type of health care or administrative services which are provided by or arranged by OhioHealthy , or another entity under contract with OhioHealthy to access OhioHealthy’s Participating Practitioner and Participating Provider Network and which are specifically described in applicable Program Attachments, Program Requirements and Program Manuals. Program Attachment means a document signed by the parties and attached to this Agreement for each Program in which Practitioner shall be participating, that sets forth certain terms and conditions applicable to such Program. Program Manual means a manual developed by OhioHealthy or another Payor for Providers and Practitioners that sets forth operational policies, procedures and requirements governing a particular Program. Program Requirements means the rules and procedures that establish conditions to be followed by Participating Practitioners and Providers with respect to Programs. Any reference to Program Requirements includes the information in this Agreement, the Program Attachments, and the Program Manuals distributed by OhioHealthy. Quality Management means the processes established and operated by OhioHealthy or its designee relating to the quality of Covered Services provided...

Participating Practitioner means a licensed health care professional who has agreed to and has been accepted by North Mississippi Health Link, Inc. to provide health care services to enrollees;

Participating Practitioner means a licensed practitioner who is authorized to prescribe drugs and who registers with the board, and is subject to rules promulgated by the board, to participate in the collection of donated drugs, prescribed for use by established patients of that practitioner and donated for the purpose of redistribution to established patients of that practitioner;

Examples of Participating Practitioner in a sentence

• I agree that “this Healthcare Organization”, its representatives, and any individuals or entities providing information to this Healthcare Organization in good faith shall not be liable, to the fullest extent provided by law, for any act or occasion related to the evaluation or verification contained in this document, which is part of the California Participating Practitioner Application.

• As set forth in this Agreement and applicable Program Attachments, as amended, Practitioner shall accept those compensation arrangements and rates set forth in this Agreement and/or the Program Attachment, as amended (or Payor or OhioHealthy supplied supplemental materials) as payment in full for those Covered Services rendered by Practitioner to Beneficiaries for those Programs in which Practitioner is a Participating Practitioner.

• This written response will be provided in writing to you, your Participating Practitioner and Landmark within thirty (30) days of the receipt of your request for review.

• To receive maximum coverage for Covered Services, the terms of this Contract must be followed, including receipt of care from In-Network Participating Practitioner and/or Providers as well as obtaining any required Certification.

• If your Participating Practitioner determines that the proposed ther- apy would be significantly less effective if not promptly initiated, the analysis and recommendations of the experts shall be rendered within seven (7) days of the request.

More Definitions of Participating Practitioner

Participating Practitioner means a health care professional who has entered into an agreement with a managed care entity to provide health care services to an enrollee in the managed care plan.

Participating Practitioner means a psychologist, clinical social worker, marriage-family therapist, or certified substance abuse counselor who has entered into an agreement as a PATH2HEALTH/CMSP with BLUE CROSS to provide Medical Services to Members as a Participating Provider and who is duly licensed in the State of California or other applicable State.

Participating Practitioner means a Medicare-enrolled physician or non-physician practitioner listed at 42 CFR § 410.78(b)(2) who: (1) is identified by an individual NPI; (2) is participating in BPCI Advanced Activities; (3) has a written agreement with the Participant that requires the Participating Practitioner to comply with all applicable terms and conditions of this Agreement; and (4) is identified on the PGP List (if the Participant is a PGP) or the Financial Arrangement List (if the Participant is not a PGP).

Participating Practitioner means a person who is licensed to practice medicine by the Medical Board of California and is board certified in medical oncology or hematology and is registered with a surplus medication collection and distribution intermediary.

Participating Practitioner means an Eligible Clinician who (1) is identified by an individual NPI; (2) is Medicare enrolled; (3) is participating in BPCI Advanced Activities; (4) has a written agreement with the Participant that requires the individual to comply with all applicable terms and conditions of this Agreement; and (5) is identified on the QPP List.

Participating Practitioner means an Eligible Clinician who: (1) is identified by an individual NPI; (2) is Medicare enrolled; (3) is participating in BPCI Advanced Activities; (4) has a written agreement with the Participant that requires the individual to comply with all applicable terms and conditions of this Agreement; and (5) is identified on the QPP List.

Participating Practitioner means a duly licensed and/or certified practitioner of a healing art or arts or other professional services who, upon application and approval by CHPC/CSI, has agreed in writing to provide Covered Services to Members in accordance with the terms and conditions of this Agreement.