Physician and Provider Options Sample Clauses

Physician and Provider Options a. Within the Empower Plan Service Area, Members are entitled to receive Covered Benefits and Services from AvMed Empower In-Network (Participating) Tier A or Tier B Providers, or from Out- of-Network (Non-Participating) Providers, as described in this Contract. b. Outside the Service Area, Members are entitled to receive Covered Benefits and Services from Out-of-Network (Non-Participating) Providers, as described in this Contract. c. Your choice of Health Professional or facility may result in lower or higher out-of-pocket expenses and you may be required to follow certain procedures to avoid additional costs. Please remember that using In-Network Providers will result in lower out-of-pocket expenses for you. You should always determine whether a provider is a Participating or a Non-Participating Provider prior to receiving services. Doing so will help inform you of the amount you are responsible for paying out-of-pocket. For more information, see Part VIII.
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Physician and Provider Options a. Within the Agility Plan Service Area, Members are entitled to receive Covered Benefits and Services from AvMed Participating (In-Network) Providers, or from Non-Participating (Out-of-Network) Providers, as described in this Contract. b. Outside the Service Area Members are entitled to receive Covered Benefits and Services from Non- Participating (Out-of-Network) Providers as described in this Contract. c. Your choice of Health Professional or facility may result in lower or higher out-of-pocket expenses and you may be required to follow certain procedures to avoid additional costs. Please remember that using Participating Providers will result in lower out-of pocket expenses for you. You should always determine whether a provider is a Participating or a Non-Participating Provider prior to receiving services. Doing so will help inform you of the amount you are responsible for paying out-of-pocket. For more information see Part VIII.
Sample 1
Physician and Provider Options a. Within the Service Area, Members are entitled to receive Covered Benefits and Covered Services from Participating Providers, or from Non-Participating Providers, as described in this Contract. Within the Service Area, Covered Benefits and Covered Services from Participating Providers will be paid at the high Benefit Level. Covered Benefits and Covered Services from Non-Participating Providers will be paid at the low Benefit Level. b. Outside the Service Area, Members are entitled to receive Covered Benefits and Covered Services from Non-Participating Providers, as described in this Contract. Covered Services from Non-ParticipatingProviders will be paid at the low Benefit Level. c. Your choice of Health Professional or facility may result in lower or higher out-of-pocket expenses and you may be required to follow certain procedures to avoid additional costs. Please remember that using Participating Providers while inside the Service Area will result in lower out- of-pocket expenses for you. You should always determine whether a provider is a Participating or a Non-Participating Provider prior to receiving services. Doing so will help inform you of the amount you are responsible for paying out-of-pocket. For more information, see Part VIII.
Sample 1Sample 2
Physician and Provider Options a. Within the Flex Plan Service Area, Members are entitled to receive Covered Benefits and Services from AvMed Flex In-Network (Participating) Providers, or from Out-of-Network (Non- Participating) Providers, as described in this Contract. b. Outside the Service Area, Members are entitled to receive Covered Benefits and Services from Out-of-Network (Non-Participating) Providers, as described in this Contract. c. Your choice of Health Professional or facility may result in lower or higher out-of-pocket expenses and you may be required to follow certain procedures to avoid additional costs. Please remember that using In-Network Providers will result in lower out-of-pocket expenses for you. You should always determine whether a provider is a Participating or a Non-Participating Provider prior to receiving services. Doing so will help inform you of the amount you are responsible for paying out-of-pocket. For more information, see Part VIII.
Sample 1Sample 2
Physician and Provider Options a. Within the Elite Plan Service Area, Members are entitled to receive Covered Benefits and Services from AvMed Elite In-Network (Participating) Providers, or from Out-of-Network (Non- Participating) Providers, as described in this Contract. b. Outside the Service Area, Members are entitled to receive Covered Benefits and Services from Out-of-Network (Non-Participating) Providers, as described in this Contract. c. Your choice of Health Professional or facility may result in lower or higher out-of-pocket expenses and you may be required to follow certain procedures to avoid additional costs. Please remember that using In-Network Providers will result in lower out-of-pocket expenses for you. You should always determine whether a provider is a Participating or a Non-Participating Provider prior to receiving services. Doing so will help inform you of the amount you are responsible for paying out-of-pocket. For more information, see Part VIII.
Sample 1Sample 2
Physician and Provider Options a. Within the Service Area, Members are entitled to receive Covered Benefits and Covered Services from Participating Providers, or from Non-Participating Providers, as described in this Contract. Within the Service Area, Covered Benefits and Covered Services from Participating Providers will be paid at the high Benefit Level. Covered Benefits and Covered Services from Non-Participating Providers will be paid at the low Benefit Level. b. Outside the Service Area, but within the State of Florida, Members are entitled to receive Covered Benefits and Covered Services from Non-Participating Providers, as described in this Contract. Covered Services from Non-Participating Providers outside the Service Area but within the State of Florida will be paid at the low Benefit Level. c. Outside the State of Florida, Members are entitled to receive Covered Benefits and Covered Services from PHCS providers and from Non-Participating Providers, as described in this Contract. Covered Services from PHCS Providers outside the State of Florida will be paid at the middle Benefit Level. Covered Services from Non-Participating Providers outside the State of Florida will be paid at the low Benefit Level. d. Your choice of Health Professional or facility may result in lower or higher out-of-pocket expenses and you may be required to follow certain procedures to avoid additional costs. Please remember that using Participating Providers while inside the Service Area, and PHCS providers while outside the State of Florida, will result in lower out-of-pocket expenses for you. You should always determine whether a provider is a Participating or a Non-Participating Provider prior to receiving services. Doing so will help inform you of the amount you are responsible for paying out-of-pocket. For more information, see Part VIII. ACCESSING COVERED BENEFITS AND
Sample 1
Physician and Provider Options a. Within the Choice Plan Service Area, Members are entitled to receive Covered Benefits and Services from AvMed Network (Participating) providers, or from Out-of-Network (Non- Participating) Providers, as described in this Contract. b. Outside the Service Area, Members are entitled to receive Covered Benefits and Services from PHCS Network or Out-of-Network (Non-Participating) Providers, as described in this Contract. c. Your choice of Health Professional or facility may result in lower or higher out-of-pocket expenses and you may be required to follow certain procedures to avoid additional costs. Please remember that using Participating Providers will result in lower out-of-pocket expenses for you. You should always determine whether a provider is a Participating or a Non-Participating Provider prior to receiving services. Doing so will help inform you of the amount you are
Sample 1
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Physician and Provider Options a. Within the Choice Plan Service Area, Members are entitled to receive Covered Benefits and Services from AvMed Choice Plan Participating (In-Network) Providers, or from Non-Participating (Out-of- Network) Providers, as described in this Contract. b. Outside the Service Area Members are entitled to receive Covered Benefits and Services from PHCS Network Providers, or from Non-Participating (Out-of-Network) Providers, as described in this Contract. c. Your choice of Health Professional or facility may result in lower or higher out-of-pocket expenses and you may be required to follow certain procedures to avoid additional costs. Please remember that using Choice Plan Participating (In-Network) Providers while inside the Service Area, and PHCS Network Providers when outside the Service Area, will result in lower out-of pocket expenses for you. You should always determine whether a provider is a Participating or a Non-Participating Provider prior to receiving services. Doing so will help inform you of the amount you are responsible for paying out-of- pocket. For more information, see Part VIII.
Sample 1

Related to Physician and Provider Options

  • Excluded Providers 4.1 Definition of Excluded Providers

  • 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 xxx.xxxxxx.xxx. 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.

  • Service Provider A public or private vendor that is funded in whole or in part using grant funds and obligated under the terms of a procurement contract with the Grantee to provide goods and/or services for the operation, management, or administration of juvenile probation services and juvenile justice programs.

  • Contractor’s Services shall be performed in accordance with generally accepted professional practices and principles and in a manner consistent with the level of care and skill ordinarily exercised by members of Contractor’s profession currently practicing under similar conditions. Contractor shall comply with the profession’s standard of performance, applicable laws, regulations, and industry standards. By delivery of completed work, Contractor certifies that the work conforms to the requirements of this Agreement and all applicable federal, state and local laws. If Contractor is retained to perform services requiring a license, certification, registration or other similar requirement under California law, Contractor shall maintain that license, certification, registration or other similar requirement throughout the term of this Agreement.

  • FULLY BARGAINED PROVISIONS This Agreement represents and incorporates the complete and final understanding and settlement by the parties on all bargainable issues which were or could have been the subject of negotiations. During the term of this Agreement, neither party will be required to negotiate with respect to any such matter, whether or not covered by this Agreement, and whether or not within the knowledge or contemplation of either or both of the parties at the time they negotiated or signed this Agreement.

  • Contractor Key Personnel ‌ The Contractor shall assign a Corporate OASIS SB Program Manager (COPM) and Corporate OASIS SB Contract Manager (COCM) as Contractor Key Personnel to represent the Contractor as primary points-of-contact to resolve issues, perform administrative duties, and other functions that may arise relating to OASIS SB and task orders solicited and awarded under OASIS SB. Additional Key Personnel requirements may be designated by the OCO at the task order level. There is no minimum qualification requirements established for Contractor Key Personnel. Additionally, Contractor Key Personnel do not have to be full-time positions; however, the Contractor Key Personnel are expected to be fully proficient in the performance of their duties. The Contractor shall ensure that the OASIS SB CO has current point-of-contact information for both the COPM and COCM. In the event of a change to Contractor Key Personnel, the Contractor shall notify the OASIS SB CO and provide all Point of Contact information for the new Key Personnel within 5 calendar days of the change. All costs associated with Contractor Key Personnel duties shall be handled in accordance with the Contractor’s standard accounting practices; however, no costs for Contractor Key Personnel may be billed to the OASIS Program Office. Failure of Contractor Key Personnel to effectively and efficiently perform their duties will be construed as conduct detrimental to contract performance and may result in activation of Dormant Status and/or Off-Ramping (See Sections H.16. and H.17.).

  • Data Necessary to Perform Services The Trust or its agent shall furnish to USBFS the data necessary to perform the services described herein at such times and in such form as mutually agreed upon.

  • Contracts With Service Providers 13 Section 1.

  • SERVICE PROVIDER’S PERSONNEL 10.1 The Service Provider’s Personnel shall be regarded at all times as employees, agents or Subcontractors of the Service Provider and no relationship of employer and employee shall arise between Transnet and any Service Provider Personnel under any circumstances regardless of the degree of supervision that may be exercised over the Personnel by Transnet. 10.2 The Service Provider warrants that all its Personnel will be entitled to work in South Africa or any other country in which the Services are to be performed. 10.3 The Service Provider will ensure that its Personnel comply with all reasonable requirements made known to the Service Provider by Transnet concerning conduct at any Transnet premises or any other premises upon which the Services are to be performed [including but not limited to security regulations, policy standards and codes of practice and health and safety requirements]. The Service Provider will ensure that such Personnel at all times act in a lawful and proper manner in accordance with these requirements. 10.4 Transnet reserves the right to refuse to admit or to remove from any premises occupied by or on behalf of it, any Service Provider Personnel whose admission or presence would, in the reasonable opinion of Transnet, be undesirable or who represents a threat to confidentiality or security or whose presence would be in breach of any rules and regulations governing Transnet's Personnel, provided that Transnet notifies the Service Provider of any such refusal [with reasons why]. The reasonable exclusion of any such individual from such premises shall not relieve the Service Provider from the performance of its obligations under this Agreement. 10.5 The Service Provider agrees to use all reasonable endeavours to ensure the continuity of its Personnel assigned to perform the Services. If any re-assignment by the Service Provider of those Personnel is necessary, or if Transnet advises that any such Personnel assigned are in any respect unsatisfactory, including where any such Personnel are, or are expected to be or have been absent for any period, then the Service Provider will promptly supply a replacement of equivalent calibre and experience, and any such replacement shall be approved by Transnet prior to commencing provision of the Services, such approval not to be unreasonably withheld or delayed.

  • Agreements with Other Service Providers Each Fund hereby appoints FSSC as the Fund’s agent to enter into agreements with financial intermediaries that are not registered as broker/dealers under the 1934 Act (each an “Unregistered Intermediary”) to provide Services to their customers that are Shareholders of the Fund. Each Fund agrees to pay Service Fees at an annual rate as set forth in Schedule 1 to this Agreement of up to 0.25% of the average net assets held in Fund accounts for which an Unregistered Intermediary has agreed to provide Services. Any such accounts shall not be treated as FSSC Accounts for purposes of this Agreement.

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