Provider or Network Provider definition

Provider or Network Provider means an appropriately credentialed and licensed individual, facility, agency, institution, organization or other entity, and its employees and subcontractors, that has a contract with the HMO for the delivery of Covered Services to the HMO’s Members.
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Provider or Network Provider means an appropriately credentialed or licensed individual, facility, agency, institution, organization or other entity that has a written agreement with aproposed QHP Bidder for the delivery of health care services.
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Examples of Provider or Network Provider in a sentence

  • Participating Provider or Network Provider is a provider, such as a Physician, Hospital, or other health facility or provider who is under a contractual agreement with this Plan to provide care or services to Covered Persons.

  • In a fast changing business environment, participation in seminars and other events are necessary for elevating your motivation level apart from knowledge and skill development.

  • Le « médiateur » est aussi désignée « la mascotte ».cahier en circulation aux domiciles des enfants, comme un « pont, jeté entre l’école et la famille » (ÉE, 1987, n°4, p.

  • The Dental Contractor is prohibited from requiring a Network Provider to obtain the insurance coverage described in Section 17.01 if the Dental Provider or Network Provider qualifies as a state governmental unit or municipality under the Texas Tort Claims Act, and is required to comply with, and subject to, the provisions of the Texas Tort Claims Act.

  • That are not payable due to the application of any specified Deductible or coinsurance or copayment provisions contained herein as well as for any service for which you are responsible under the terms of this Plan to pay a Copayment, Coinsurance or Deductible, and the Copayment, Coinsurance or Deductible is waived by a Non-Network Provider or Network Provider.

  • HHSC’s written approval is not required in the following situation: The Dental Contractor or a Network Provider is not required to obtain insurance coverage described in Section 17.01 if the Dental Provider or Network Provider qualifies as a state governmental unit or municipality under the Texas Tort Claims Act, and is required to comply with, and are subject to, the provision of the Texas Tort Claims Act.

  • The Customer Domain area represents a second TMN, which could be a business customer, or another Service Provider or Network Provider, such as an inter-exchange carrier, competitive local exchange carrier (CLEC), Internet Service Provider (ISP), etc.

  • A number of respondents, acting on the advice given by PhonepayPlus, needed to contact their Service Provider or Network Provider again.

  • Please select the Cover, Network type, No. of claims per year and Sublimit (if any) Select the Network Type: Network Non NetworkNetwork – You can visit our Health Service Provider or Network Provider for claims on cashless basisNon Network – You can visit a dentist of your choice and submit claim on reimbursement basis HDFC ERGO General Insurance Company Limited.

  • Service Provider agrees and shall require Network Providers to agree that all provisions of this Addendum shall apply equally to any employees, independent contractors, and subcontractors that Service Provider or Network Provider engages in connection with the Medicaid Products, and Service Provider or Network Provider, as applicable, shall cause such employees, independent contractors, and subcontractors to comply with this Addendum, the State Contract(s), and Applicable Law.

Related to Provider or Network Provider

  • Non-Network Provider means any hospital, day care centre or other provider that is not part of the network.

  • Network Provider 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.

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

  • Provider panel means those providers with which a carrier contracts to provide health care services

  • Provider is any individual or company that provides professional or technical services.

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • Hub Provider means an entity that (i) provides Common Channel Signaling (SS7) connectivity between the networks of service providers that are not directly connected to each other; or (ii) provides third party database services such as LIDB. The SS7 messages received by Hub Providers are accepted or rejected by the Hub Provider depending on whether a contractual arrangement exists between the Hub Provider and the message originator (sender) and whether the message originator has contracted for the type of SS7 messages being submitted for transmission to the Hub Provider.

  • New Provider means any replacement service provider or providers engaged to provide the Services (or part thereof) or substantially similar services or the Authority itself where the Services or substantially similar services or part thereof continue to be provided by the Authority after partial termination, termination or expiry of this Contract;

  • Out-of-network provider means any provider that is not directly or indirectly employed by or does not have a provider agreement with the contractor or any of its subcontractors pursuant to the contract between the department and the contractor.

  • Provider Personnel means all persons employed or engaged by the Provider together with the Provider’s servants, agents, consultants and Sub-Contractors (and all persons employed by any Sub-Contractor together with the Sub-Contractor’s servants, consultants, agents, Provider’s and Sub-Contractors) used in the performance of its obligations under this Agreement;

  • Provider Service means a Provider’s hosted online services (if any) as described in the Solution Exhibit which is provided by Provider to Customers located in the Territory through remote access via the Internet as part of the BPO Service. A Provider Platform Application shall be considered a Provider Service.

  • Internet Service Provider (ISP) means an Enhanced Service Provider (ESP) that provides Internet Services.

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

  • 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.

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

  • Local Service Provider (LSP means the LEC that provides retail local Exchange Service to an End User. The LSP may or may not provide any physical network components to support the provision of that End User’s service.

  • Third Party Provider means licensors, subcontractors and suppliers of BNYM furnishing the Third Party Products.

  • Provider Organization means a group practice, facility, or organization that is:

  • Data Provider means a Participant that is registered to provide information to GS1 South Africa for use through the Verified by GS1 Services.

  • 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.

  • ACS means “asset-controlling supplier” as that term is defined in the Cap and Trade Regulations.

  • Education service provider means an education management organization, school

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

  • Internet Service Provider (ISP) is an Enhanced Service Provider that provides Internet Services, and is defined in paragraph 341 of the FCC’s First Report and Order in CC Docket No. 97-158.

  • 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.

  • Provider agreement means the signed, written, contractual agreement between the department and the provider of services or goods.