PREFERRED PROVIDER NETWORK Sample Clauses

PREFERRED PROVIDER NETWORK. A group of hospitals and physicians approved and contracted to treat Insureds on behalf of the Insurer. The list of hospitals and physicians in the Preferred Provider Network is available from USA Medical Services and may change at any time without prior notice.

PREFERRED PROVIDER NETWORK. The Plan Bupa Select policy provides coverage in the Preferred Provider Network only, regardless of whether the treatment is in your country of residence or outside your country of residence. There is no cover- age outside the Preferred Provider Network, except for emergencies. (a) In order to ensure that the provider of medical services is in the Preferred Provider Network, all treatment, except emergen- cies, must be coordinated by USA Medical Services. (b) In those cases where the Preferred Provider Network is not specified in your country of residence, there is no restriction on which hospitals may be used in your country of residence.

PREFERRED PROVIDER NETWORK. A group of hospitals and physicians approved and contracted to treat Insureds on behalf of the Insurer. The list of hospitals and physicians in the Preferred Provider Network is available from Redbridge Network & Healthcare, Inc and may change at any time without prior notice.

PREFERRED PROVIDER NETWORK. Contractor shall: 1. Make its PPO network of Providers available to Participants in the Plan. Contractor shall require Providers to accept the Contractor’s reimbursement amount as payment in full less any patient responsibility (e.g. deductibles and coinsurance) for covered services rendered by Providers to Participants under County’s Plan. Contractor’s negotiated rate will result in Plan discounts. 2. Provide and maintain its PPO network information on Contractor’s website. 3. Provide appropriate referrals to the website, or provide assistance in locating a PPO provider upon request by a Participant. 4. Provide the County with management reports similar to those listed below on utilization of the PPO: (Such reports shall be based on data available to the Contractor). Reports shall be presented quarterly. a. Dental Experience Report / Executive Summary b. Dental Utilization by Service Category c. Provider Report by PPO Indicator and Provider Type d. The reports described shall be provided electronically and in hard copy. 5. Assist the County in interpreting the reports and shall make recommendations for improving cost-effective utilization of dental care for Participants.

PREFERRED PROVIDER NETWORK. An organization responsible for maintaining and providing a network of medical providers to perform medical services for CDCR/CCHCS patients and/or DJJ youth.

PREFERRED PROVIDER NETWORK. The Azpas International Group policy provides coverage in the Preferred Provider Network only, regardless of whether the treatment is in your country of residence or outside your country of residence. There is no coverage outside the Preferred Provider Network, except for emergencies. (a) In order to ensure that the provider of medical services is in the Preferred Provider Network, all treatment, except emergencies, must be coordinated by Redbridge Network & Healthcare, Inc. (b) In those cases where the Preferred Provider Network is not specified in your country of residence, there is no restriction on which hospitals may be used in your country of residence.

PREFERRED PROVIDER NETWORK. In plan year 2016, the preferred provider network is Blue Choice. Effective January 1, 2017, the preferred provider network will be Blue Preferred offered by Blue Cross and Blue Shield of Oklahoma.

PREFERRED PROVIDER NETWORK. We will cover the Medical Expenses for an Insured Person only in Hospitals that are part of the Preferred Provider Network that agree on negotiated rates as defined and specified in the Policy Schedule or Certificate of Insurance.

PREFERRED PROVIDER NETWORK. Contractor shall:

PREFERRED PROVIDER NETWORK. Contractor shall: 1. Make its PPO network of Providers available to Participants in the Plans. Contractor shall require Providers to accept the Contractor’s reimbursement amount as payment in full less any patient responsibility (e.g. deductibles and coinsurance) for covered services rendered by Providers to Participants under County’s Plans. Contractor’s negotiated rate will result in health Plan discounts. 2. Notify the County within 60 days prior to the termination of the following: (1) any network hospital in Southern California, (2) any medical group or medical provider utilized by more than 100 County participants in a 12-month period and (3) any lab or diagnostic provider utilized by more than 100 County participants in a 12-month period. 3. Provide and maintain its PPO network information on Contractor’s website. 4. Provide appropriate referrals to the website, or provide assistance in locating a PPO provider upon request by a Participant. 5. Provide the County with management reports similar to those listed below on utilization of the PPO programs: (Such reports shall be based on data available to the Contractor). Reports shall be presented quarterly. a. Health Experience Report / Executive Summary b. Hospital Utilization by Diagnostic Category c. Provider Report by PPO Indicator and Type d. County-specific care coordination fees for value-based care providers e. Quality metrics and outcomes under value-based arrangements for attributed members f. The reports described shall be provided electronically and hard copy 6. Assist the County in interpreting the reports and shall make recommendations for improving cost-effective utilization of health care for Participants.