Hospital Providers Clause Samples

Hospital Providers. If Provider is a hospital (including a psychiatric hospital): a. Provider shall cooperate with ACDE in developing and implementing protocols as part of ACDE’s nursing facility diversion plan, which shall include, at a minimum, Provider’s obligation to promptly notify ACDE upon admission of an eligible Member, regardless of payor source for the hospitalization. As part of the discharge planning process with ACDE’s care management staff, hospital Provider will identify Members who may need home health, nursing facility, or home & community-based services (HCBS) upon discharge. Hospital Provider and ACDE will work together in the discharge planning process to ensure that Members receive the most appropriate and cost-effective Medically Necessary services upon discharge. Agency Contract §3.10.2.1.57. b. Provider shall cooperate with ACDE in implementing an inpatient behavioral health UM strategy. Provider shall collaborate with identified outpatient behavioral health providers when admitting Members for acute behavioral health treatment; and, within twenty-four
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Hospital Providers. Provider shall have a sufficient number of Hospital Providers to provide Covered Services and meet the needs of Health Plan and its Members as determined by Health Plan’s Quality Improvement Program and in accordance with state and federal law. Provider shall be responsible for the Covered Services provided by Hospital Providers.
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Hospital Providers. Hospital providers must be qualified to provide services. All services must be provided in accordance with applicable state and federal laws and regulations. Neonates who have received the maximal benefit of specialized care but are not yet ready to be discharged may be transported back to the hospital from which they originated, if appropriate (back transport). The hospital is responsible for determining if the neonate should be back transported.
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Hospital Providers. Hospital services providers must be qualified to provide services under the Medicaid program. All services must be provided in accordance with applicable state and federal laws and regulations and adhere to the requirements set forth in the CCN-P Policy and Procedure Guide.
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Hospital Providers. As applicable, Provider must register all births through LEERS (Louisiana Electronic Event Registration System) administered by the LDH/Vital Records Registry. Hospital Providers must notify United and LDH of the birth of a newborn when the mother is a member of United, complete the web-based LDH Request for Medicaid ID Number, including indicating that the mother is a member of United, and submit the form electronically to LDH within fifteen (15) calendar days.
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Hospital Providers. 100% of the Medicare allowed amount applicable to the Provider as published annually and based on valid codes recognized by CMS in effect on the date of service, less applicable Copayments, Coinsurance and Deductibles.
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Related to Hospital Providers

  • Hospital Services The Hospital will: 6.1.1 achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; 6.1.2 not reduce, stop, start, expand, cease to provide or transfer the provision of Hospital Services to another hospital or to another site of the Hospital if such action would result in the Hospital being unable to achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; and 6.1.3 not restrict or refuse the provision of Hospital Services that are funded by the Funder to an individual, directly or indirectly, based on the geographic area in which the person resides in Ontario, and will establish a policy prohibiting any health care professional providing services at the Hospital, including physicians, from doing the same.

  • Providers Services performed by a provider who has been excluded or debarred from participation in federal programs, such as Medicare and Medicaid. To determine whether a provider has been excluded from a federal program, visit the U.S. Department of Human Services Office of Inspector General website (▇▇▇▇▇://▇▇▇▇▇▇▇▇▇▇.▇▇▇.▇▇▇.▇▇▇/) or the Excluded Parties List System website maintained by the U.S. General Services Administration (▇▇▇▇▇://▇▇▇.▇▇▇.gov/). • Services provided by facilities, dentists, physicians, surgeons, or other providers who are not legally qualified or licensed, according to relevant sections of Rhode Island Law or other governing bodies, or who have not met our credentialing requirements. • Services provided by a non-network provider, unless listed as covered in the Summary of Medical Benefits. • Services provided by naturopaths, homeopaths, or Christian Science practitioners.

  • Hospital Any institution which is legally licensed as a medical or surgical facility in the country in which it is located, which is a) primarily engaged in providing diagnostic and therapeutic facilities for clinical and surgical diagnosis, treatment and care of injured and sick persons by or under the supervision of a staff of physicians; and b) not a place of rest, a place for the aged or nursing or convalescent home or institution or a long term care facility.

  • Participating Providers To find out if a Provider is a Participating Provider: • Check Our Provider directory, available at Your request; • Call the number on Your ID card; or • Visit our website at ▇▇▇.▇▇▇▇▇▇.▇▇▇. The Provider directory will give You the following information about Our Participating Providers: • Name, address, and telephone number; • Specialty; • Board certification (if applicable); • Languages spoken; and • Whether the Participating Provider is accepting new patients.

  • Health Care Operations “Health Care Operations” shall have the same meaning as the term “health care operations” in 45 CFR §164.501.