Plan Providers definition

Plan Providers means the physicians, hospitals, skilled nursing facilities, home health agencies, pharmacies, medical transportation companies, laboratories, radiology and diagnostic facilities, durable medical equipment suppliers and other licensed health care entities or professionals who are part of the selected Plan Network and who provide Benefits to Members through an agreement with Plan. Plan Providers are listed in the Provider Directory. For purposes of Mental Health or Substance Use Disorders, Plan Providers also include :
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Plan Providers means the physicians, hospitals, skilled nursing facilities, home health agencies, pharmacies, medical transportation companies, laboratories, radiology and diagnostic facilities, durable medical equipment suppliers and other licensed health care entities or professionals who are part of the selected Plan Network and who provide Benefits to Members through an agreement with Plan. Plan Providers also include Qualified Autism Service Providers, Qualified Autism Service Professionals, and Qualified Autism Service Paraprofessionals who are part of the Member’s Plan Network and who provide Covered Benefits to Members through an agreement with Plan. Plan Providers are listed in the Provider Directory.
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Plan Providers has the meaning set forth in Recital C.
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Examples of Plan Providers in a sentence

  • If you still refuse to accept the recommended Services, the Health Plan and Plan Providers have no further responsibility to provide or cover any alternative treatment you may request for that condition.

  • This policy applies to all IEHP DualChoice Cal MediConnect Plan (Medicare – Medicaid Plan) Providers.

  • Additionally, your Primary Care Plan Physician and Plan Providers will work as a team, along with you, to ensure continuity of care and medically appropriate courses of treatment.Each Member in your family should select a Primary Care Plan Physician.

  • Plan Providers are paid in various ways, including salary, capitation, per diem rates, case rates, fee for service and incentive payments.

  • We are available to assist you 24/7.If your Primary Care Plan Physician is in our Network of Plan Providers, but not located in a Plan Medical Center, please contact his/her office directly for assistance making or canceling an appointment.

  • Pharmacy, optical, laboratory and X-ray facilities are also available at many Plan Medical Centers.You must receive care from Plan Providers within our Service Area, except for:1.

  • Kaiser Permanente SignatureSM provides you with health care Services administered by Plan Providers at our Plan Medical Centers, which are conveniently located throughout our Service Area.

  • You may receive these Services and other benefits specified in this Agreement when provided, prescribed or directed by Plan Providers within our Service Area.You have your choice of Plan Physicians and Facilities within our Service Area.

  • Liability of Subscribers in the Event of Non-Payment by Blue ShieldIn accordance with Blue Shield’s established poli- cies, and by statute, every contract between Blue Shield and its Plan Providers stipulates that the Sub- scriber shall not be responsible to the Plan Provider for compensation for any services to the extent that they are provided in the Member’s group contract.

  • Retirement Plan Providers acting in such capacity will provide some or all of the shareholder services to their customers as set forth in the Pricing Agreements from time to time.

Related to Plan Providers

  • Plan Provider means a Provider which has a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered to you.

  • Non-Plan Provider means a Provider that does not meet the definition of Plan Provider unless otherwise specified in the definition of a particular Provider.

  • Data Providers means pricing vendors, analytics providers, brokers, dealers, investment managers, Authorized Persons, Subcustodians, Depositories and any other Person providing Market Data to the Custodian.

  • Service Providers has the meaning set out in Section 9(e).

  • Participating provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • Training provider means an organization meeting the eligibility conditions as mentioned in Data Sheet and selected in accordance with the criteria set forth for the purpose.

  • Providers means individuals or organizations --------- licensed to practice dentistry (including specialists) as well as other dental professionals who provide ancillary reimbursable dental services.

  • Third Party Service Providers means any third party wherever situated selected by us or any member of the BEA Group to provide services to it.

  • The Service Provider means the organization or firm providing the services under this Contract.

  • Service Provider Personnel means and refers to Service Provider employees or subcontractors hired and maintained to perform Services hereunder.

  • Housing Provider means, with respect to a HOME Development, Local Government, consortia approved by HUD under 24 CFR Part 92, for-profit and Non-Profit Developers, and qualified CHDOs, with demonstrated capacity to construct or rehabilitate affordable housing.

  • Nonparticipating provider means a person, health care provider, practitioner, facility, or entity, acting within their scope of practice, that does not have a written contract to participate in a managed health care system's provider network, but provides health care services to enrollees of programs authorized under this chapter or other applicable law whose health care services are provided by the managed health care system.

  • Common Service Provider means a person nominated by the ICSDs to perform the role of common service provider;

  • Non-Participating Provider means an Administrator Hospital or Professional Provider which does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or a facility which has not been designated by the Claim Administrator as a Participating Provider.

  • Third Party Providers or “TPPs” means any payment service provider that provides payment services to you or someone else that concerns the Account, for example, an AISP (described in Clause 1(c) below).

  • Professional Provider means a Physician, Dentist, Podiatrist, Psychologist, Chiropractor, Optometrist or any Provider designated by the Claim Administrator or another Blue Cross and/or Blue Shield Plan.

  • Individual provider means an individual provider as defined

  • Medical Executive Committee or “MEC” means the Executive Committee of the Medical Staff.

  • Medical provider means a medical service provider, a hospital, a medical clinic, or a vendor of medical services.

  • Education service provider means an education management organization, school

  • Information Service Provider A provider of Information Service. Information Service Provider includes, but is not limited to, Internet Service Providers (ISPs).

  • Account Information Service Provider means a payment service provider pursuing business activities as referred to in point (8) of Annex I;

  • Enhanced Service Provider (ESP means the provider of enhanced services, as those services are defined in 47 CFR Section 64.702.

  • ProviderOne or “P1” means the system commonly referred to as the Medicaid Management Information System (MMIS), and is the federally approved system used by the Washington Medicaid program to pay provider claims for goods and services authorized under the State Plan. The MMIS is certified by CMS and is the primary information system used by HCA to pay for health care.

  • Principals or Key Personnel means and refers to those principals and key personnel of the Contractor, and its or their agents, as described in C.G.S. §§ 4-250(5) and 4-252(c)(1)(B) and (C).