Health Services Payments by Sponsor to MSI Sample Clauses

Health Services Payments by Sponsor to MSI. (a) Network Provider Physician and Allied Professional Health Services Amounts paid for Health Services as established by the terms of the Network Provider Agreement with MSI, less any Copayment, Coinsurance and/or Deductible Amounts. Payment to providers to provide Patient-Centered Medical Homes will be in addition to claims for medical services. Providers associated with care coordination are subject to statistical evaluation to assess the impact of the patient-centered medical home on clinical outcomes, patient experience and cost. Care coordination fees will be prospectively adjusted accordingly.
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Related to Health Services Payments by Sponsor to MSI

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  • Office Visits (other than Preventive Care Services) This plan covers office and clinic visits to diagnose or treat a sickness or injury. Office visit copayments differ depending on the type of provider you see. This plan covers physician visits in your home if you have an injury or illness that: • confines you to your home; or • requires special transportation; and • because of this injury or illness, you are physically unable to travel to the provider’s

  • Outpatient emergency and urgicenter services within the service area The emergency room copay applies to all outpatient emergency visits that do not result in hospital admission within twenty-four (24) hours. The urgicenter copay is the same as the primary care clinic office visit copay.

  • Clinical Management for Behavioral Health Services (CMBHS) System The CMBHS is the official record of documentation by System Agency. Grantee shall:

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