Provider and Payor Relationships. The Practice Advisory Council shall review and make recommendations to the Practice regarding the establishment or maintenance of relationships between the Practice and institutional health care providers and third-party payors, and the Practice shall review and approve all agreements with institutional health care providers and third-party payors. The Practice Advisory Council shall also make recommendations to the Practice concerning discounted fee schedules, including capitated fee arrangements of which the Practice shall be a party, and the Practice shall review and approve all such capitated fee arrangements.
Provider and Payor Relationships. The Advisory Board shall review and advise Manager and Practice with respect to the establishment or maintenance of relationships with institutional healthcare providers and payors.
Provider and Payor Relationships. Manager, upon request of Practice, shall consult with Practice on matters relating to the establishment or maintenance of relationships with institutional healthcare providers and third-party payors, including, but not limited to, managed care programs, health maintenance organizations and preferred provider organizations. Practice shall not be required by Manager to sign up or contract with any particular provider or payor.
Provider and Payor Relationships. Administrator shall provide financial and business assistance to the Group in the negotiation, establishment, supervision and maintenance of contracts and relationships (collectively, the "Managed Care Contracts") with all managed care, institutional health care providers and payors, health maintenance organizations, preferred provider organizations, exclusive provider organizations, Medicare, Medicaid, insurance companies, hospitals and other similar persons (collectively, "Managed Care Payors"). Approval, disapproval, termination or amendment of any contract or relationship of such Managed Care Payors with the Group shall, after consultation with the Joint Planning
Provider and Payor Relationships. Administrator shall provide financial and business assistance to the Group in the negotiation, establishment, supervision and maintenance of contracts and relationships (collectively, the "Managed Care Contracts") with all managed care, institutional health care providers and payors, health maintenance organizations, preferred provider organizations, exclusive provider organizations, Medicare, Medicaid, insurance companies, hospitals and other similar persons (collectively, "Managed Care Payors"). Approval, disapproval, termination or amendment of any contract or relationship of such Managed Care Payors with the Group shall, after consultation with the Joint Planning Board, be the responsibility of the Group. [Notwithstanding the preceding language, if a contract or relationship between any Managed Care Payor and the Group involves or affects a contract or relationship with any other physician group or practice serviced or managed by Administrator, Parent or any of their Affiliates (the "Other Practices") and a consensus among the Group and the Other Practices cannot be reached regarding the contract or relationship, then the ultimate decision as to the approval, disapproval, termination or amendment of such contract or relationship involving the Group, the Other Practices and such Managed Care Payor shall be determined by the affirmative vote of the Physician Board Members (as defined below) who hold a majority of the Group Voting Power (as defined below). For purposes of this Section 3.7, (i) the term "Physician Board Members" shall mean (a) those members appointed by the Group who serve on the Joint Planning Board and (b) those persons appointed by the Other Practices who serve on the Other Practices' joint boards (in a similar capacity to the Joint Planning Board) as
Provider and Payor Relationships. The Practice Advisory Council shall review and make recommendations to Business Manager and the Practice regarding the establishment or maintenance of relationships between the Practice and institutional health care providers and third-party payors, and shall review and approve all agreements with institutional health care providers and third-party payors which contain terms which are materially different from those terms set forth in guidelines established by the Local Advisory Council. The Practice Advisory Council shall also make recommendations to Business Manager and the Practice concerning discounted fee schedules, including capitated fee arrangements of which the Practice shall be a party, and shall review and approve all such capitated fee arrangements.
Provider and Payor Relationships. Subject to Section 3.3: (i) decisions regarding the establishment or maintenance of contractual relationships between Provider and outside or institutional dental care providers and third-party payors shall be subject to the review and recommendations of the Policy Board; and (ii) all discounted fee practices and schedules, including individual provider or specialty discount arrangements, preferred provider organization discounts and capitated fee arrangements, shall be subject to the review and recommendations of the Policy Board. Where there is no clear methodology for the allocation of capitated fees among Provider’s Dental Care Professionals, the Policy Board shall recommend the methodology intended to result in the equitable and appropriate allocation of all related fees consistent with the type and utilization of Dental Care covered under the capitation arrangement.
Provider and Payor Relationships. The Policy Council shall make the decisions regarding the establishment and maintenance of relationships with institutional health care providers and payors. The Policy Council shall be responsible for approving the allocation of capitation risk pools between the professional and institutional components of these pools to the extent applicable under a payor agreement. ProMedCo-Temple and KDCP may choose to use actuarial data from a nationally recognized actuarial firm as agreed to by both parties, for the purposes of allocating capitation funds, for those professional services provided directly by KDCP.
Provider and Payor Relationships. Decisions regarding the -------------------------------- establishment or maintenance of relationships with institutional health care providers and payors shall be made by the Practice in consultation with the Management Team.
Provider and Payor Relationships. The Policy Council shall make the decisions regarding the establishment and maintenance of relationships with institutional health care providers and payors. The Policy Council shall be responsible for approving the allocation of capitation risk pools between the professional and institutional components of these pools to the extent applicable under a payor agreement. ProMedCo and CPC shall use actuarial data from a nationally recognized actuarial firm as agreed to by both parties, for the purposes of allocating capitation funds, for those professional services provided directly by CPC.
