Nonparticipating Providers Sample Clauses

Nonparticipating Providers. Medical Group is not obligated to arrange for Nonparticipating Providers to provide Covered Services in Special Circumstances to New Members if the Nonparticipating Provider (i) fails to agree in writing to be subject to the same contractual terms and conditions that are imposed upon Medical Group’s currently contracted participating providers providing similar services who are not capitated and who are practicing in the same or a similar geographic region as the Nonparticipating Provider, including, but not limited to, credentialing, hospital privileging, utilization review, peer review, and quality assurance requirements, or (ii) has not agreed in advance to compensation terms for the provision of Covered Services in Special Circumstances to New Members, or does not otherwise accept payment rates for such services, at rates (and methods of payment) similar to those used by Medical Group for currently contracting providers providing similar services who are not capitated and who are practicing in the same or a similar geographic area as the Nonparticipating Provider.
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Nonparticipating Providers. When the beneficiary or sponsor submits the claim to the CHAMPUS fiscal inter- mediary (that is, the provider elects not to participate), an itemized bill from the provider to the beneficiary or sponsor must be attached to the CHAMPUS claim form.
Sample 1
Nonparticipating Providers. New Members may continue an on-going course of treatment with a Nonparticipating Provider for a transitional period of up to sixty (60) days from the effective date of their Keystone coverage when approved by Keystone in advance of receiving services. Keystone, in consultation with the Member and the health care Provider, may extend this transitional period if determined to be clinically appropriate. If the new Member is in the second or third trimester of pregnancy, the transitional period will be extended to postpartum care related to the delivery. Members wishing to receive continuing care from a Nonparticipating Provider for a transitional period must obtain Preauthorization for the requested services from Keystone. All terms and conditions of this Agreement, including Preauthorization requirements, will apply during any transitional period. Additionally, the Nonparticipating Provider must agree to accept Xxxxxxxx’s reimbursement as payment in full.‌
Sample 1

Related to Nonparticipating Providers

  • 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 (xxxxx://xxxxxxxxxx.xxx.xxx.xxx/) or the Excluded Parties List System website maintained by the U.S. General Services Administration (xxxxx://xxx.xxx.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.

  • Third Party Providers Except for those terms and conditions that specifically apply to Third Party Providers, under no circumstances shall any other person be considered a third party beneficiary of this Agreement or otherwise entitled to any rights or remedies under this Agreement. Except as may be provided in Third Party Agreements, Company shall have no rights or remedies against Third Party Providers, Third Party Providers shall have no liability of any nature to the Company, and the aggregate cumulative liability of all Third Party Providers to the Company shall be $1.

  • Service Providers Provider shall enter into written agreements with all Service Providers performing functions pursuant to this Agreement, whereby the Service Providers agree to protect Student Data in manner no less stringent than the terms of this DPA. The list of Provider’s current Service Providers can be accessed through the Provider’s Privacy Policy (which may be updated from time to time).

  • Contracts With Service Providers 13 Section 1.

  • Third Party Service Providers Unless otherwise prohibited by Apple in the Documentation or this Agreement, You are permitted to employ or retain a third party (“Service Provider”) to assist You in using the Apple Software and Services provided pursuant to this Agreement, including, but not limited to, engaging any such Service Provider to maintain and administer Your Applications’ servers on Your behalf, provided that any such Service Provider’s use of the Apple Software and Services or any materials associated therewith is done solely on Your behalf and only in accordance with these terms. Notwithstanding the foregoing, You may not use a Service Provider to submit an Application to the App Store or use TestFlight on Your behalf. You agree to have a binding written agreement with Your Service Provider with terms at least as restrictive and protective of Apple as those set forth herein. Any actions undertaken by any such Service Provider in relation to Your Applications or use of the Apple Software or Apple Services and/or arising out of this Agreement shall be deemed to have been taken by You, and You (in addition to the Service Provider) shall be responsible to Apple for all such actions (or any inactions). In the event of any actions or inactions by the Service Provider that would constitute a violation of this Agreement or otherwise cause any harm, Apple reserves the right to require You to cease using such Service Provider.

  • Stock Plan Administration Service Providers The Company transfers Data to Xxxxxx Xxxxxxx Xxxxx Xxxxxx LLC, an independent service provider, which is assisting the Company with the implementation, administration and management of the Plan. In the future, the Company may select a different service provider and share Data with such other provider serving in a similar manner. The Participant may be asked to agree on separate terms and data processing practices with the service provider, with such agreement being a condition to the ability to participate in the Plan.

  • Agreement to Provide Information Intermediary agrees to provide the Fund, upon written request, the taxpayer identification number (“TIN”), the Individual Taxpayer Identification Number (“ITIN”), or other government-issued identifier (“GII”), if known, of any or all Shareholder(s) of the account and the amount, date, name or other identifier of any investment professional(s) associated with the Shareholder(s) or account (if known), and transaction type (purchase, redemption, transfer, or exchange) of every purchase, redemption, transfer, or exchange of Shares held through each account maintained by the Intermediary during the period covered by the request.

  • Obligation to Provide Information Each party’s obligation to provide information shall be as follows:

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