Tiered network definition

Tiered network means a network that identifies and groups some or all types of providers and facilities into specific groups to which different provider reimbursement, covered person cost-sharing, or provider access requirements, or any combination thereof, apply for the same services.

Tiered network means a network that identifies and

Tiered network means a network that identifies and groups some or all types of

Examples of Tiered network in a sentence

• Tiered network plans should be handled separately (i.e., the relativity between a tiered network bronze plan should maintain a relativity between 0.710 and 0.770 to a tiered network silver plan, all other things being equal).

• Tiered network products separate provid- ers into higher or lower tiers based on cost efficiency,quality performance, and other factors; consumers may then use any of the network providers, but pay lower out-of-pocket costs if they choose a provider in a lower cost tier.XXVI This difference in cost sharing is intended to encourage patients to use these providers that the payer has identified as being efficient.

• Tiered network products hold promise, but current approaches are weakened by mixed incentives for consumers to obtain care at higher value providers.In this section, we examine another demand side initiative: insurance products that reward consumers with lower copayments and/or coinsurance for obtaining care at lower cost, high quality providers (called “better value” or “higher value” providers).

• With this understanding of the Alaskan Oil and Gas Production Tax established, I turn now towards a policy discussion regarding the creation of this tax and its revenue allocation.

• If a product is a combination of two types of network products (e.g., a Regional Tiered network product), please default to reporting the product as a Tiered network product and follow the reporting guidelines that apply to Tiered network products.

More Definitions of Tiered network

Tiered network means a network of Healthcare Providers for which (i) an Insurer divides the in-network Providers into different sub-groups based on objective price,

Tiered network means a network that identifies and groups some or all types of health care providers and facilities into specific groups to which different participating provider reimbursement, covered person cost-sharing or participating provider access requirements, or any combination thereof, apply for the same health care services.

Tiered network means a provider network in which: (i) providers are assigned to, or placed in, different benefit tiers, as determined by Tiering; and (ii) patients receive benefits and pay the copayment, coinsurance, or deductible amounts that are associated with the benefit tier to which the provider from whom services were received is assigned.

Tiered network or “tiering” means a network of participating providers which has been divided into sub-groupings differentiated by the health insurer according to cost-sharing levels, provider payment, performance ratings, quality scores, or any combination of these or other factors established as a means of influencing the insured person’s choice of provider.

Tiered network means a network that supports a health benefits plan in which there

Tiered network means a network that identifies and assigns some or all types of providers and facilities into specific groups to which different provider reimbursement, covered person cost-sharing, or provider access requirements, or any combination of reimbursement, cost-sharing, and access requirements, apply for the same service.

Tiered network means a network of participating providers that has been divided into sub-groupings differentiated by the carrier according to cost-sharing levels, provider payment, performance ratings, quality scores, or any combination of these or other factors established as a means of influencing the enrollee’s choice of provider.