Provider Information. BCBSM may disclose Provider specific information as follows:
a. pursuant to any federal, state or local statute or regulation;
b. to customers for purpose of audit and health plan administration so long as the customer agrees to restrict its use to these purposes;
c. for purposes of public reporting of benchmarks in utilization management and quality assessment initiatives, including publication in databases for use with all consumer driven health care products, or other similar BCBS business purposes;
d. for civil and criminal investigation, prosecution or litigation to the appropriate law enforcement authorities or in response to appropriate legal processes.
Provider Information. All services will be furnished in full compliance with the non-discrimination requirements of Title VI of the Federal Civil Rights Act, Section 504 of the Rehabilitation Act of 1973 and the Standards of Privacy of Individual Identifiable Health Information, the Electronic Transactions Standards and the Security Standards under the Health Insurance Portability and Accountability Act of 1996 as enacted, promulgated and amended from time to time. I understand that payment and satisfaction of all claims will be from Federal and State funds and that any false claims, statements, or documents, or concealment of a material fact, may be prosecuted under applicable Federal or State laws, or both.
Provider Information. Avesis shall make available to Members, through the Avesis and/or the Sponsor’s website or through a toll-free customer service telephone number, the names, addresses, phone numbers and specialties of all of the Providers who agree to participate under each Sponsor’s plan.
Provider Information. NOTE: THIS INFORMATION SHOULD ONLY BE THE INFORMATION OF A NEW JERSEY MEDICAID PROVIDER. IF YOU ARE A SECONDARY BILLING SERVICE, PLEASE ADD A SUPPLEMENTARY SECTION 3 AND PLACE BILLING SERVICE INFORMATION ONLY IN SECTION 3.
Provider Information. American Home Shield Corporation is the provider of this Plan Agreement for Covered Homes located in Alabama, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, West Virginia, and Wyoming. American Home Shield of Florida, Inc. is the provider of this Plan Agreement for Covered Homes located in Florida. American Home Shield of Iowa, Inc. is the provider of this Plan Agreement for Covered Homes located in Iowa. American Home Shield of Maine, Inc. is the provider of this Plan Agreement for Covered Homes in Maine and Massachusetts. American Home Shield of Oklahoma, Inc. is the provider of this Plan Agreement for Covered Homes located in Oklahoma. American Home Shield of Virginia, Inc. is the provider of this Plan Agreement for Covered Homes located in Virginia. American Home Shield of Washington, Inc. is the provider of this Plan Agreement for Covered Homes located in Washington.
Provider Information. Provider agrees that now and hereafter Blue Shield may utilize, publish, disclose and display information relating to Provider and/or to the Agreement to entities, including, but not limited to, current and potential group customers and their agents or designees, the Blue Cross and Blue Shield Association and its related plans, participating providers, and current and potential members, using those formats and media (including, without limitation, marketing materials, other publications, directories and internet) that are most appropriate under the specific circumstances, such information to include, but not be limited to, Provider’s name, address and telephone number; description of Provider’s services; descriptive and educational information, including the results of customer satisfaction surveys concerning Provider and its services, facilities and staff; information relating to Provider’s costs, charges, payment rates and/or amounts for services hereunder, patient pay amounts (including coinsurance amounts), quality, utilization, and data relating to Provider’s delivery of health care; and any data, information and conclusions generated in connection with a Blue Shield designed program, report and/or study regarding Provider and/or other participating providers.
Provider Information. Provider Name* Complete legal name of institution, corporate entity, practice or individual provider. Doing Business as Name (DBA) A legal term used in the United States meaning that the trade name, or fictitious business name, under which the business or operation is conducted and presented to the world is not the legal name of the legal person (or persons) who actually own it and are responsible for it.
Provider Information. 16 1. Service Level Agreement (SLA) – Provider will define guaranteed response times related to 17 SLA and the SLA’s must be mutually agreed upon.
Provider Information. The following affiliates and subsidiaries of Provider are incorporated into this Agreement:
Provider Information. (1) The MCO must submit annually by April 15th of the Contract Year a complete list of Participating Providers, including name, specialty, and address, in a format approved by the STATE using a current version of Excel. For MSHO, providers of Medicare and Medicaid services must be included. The MCO shall also submit an update of its list of Participating Providers, in the same format, by the 15th day of October of the Contract Year. (Note: this excludes pharmacies, transportation providers, and interpreters.)
(2) The MCO must submit annually by April 15th of the Contract Year, a list of the names, types of service(s) provided, and counties of service of all Home and Community-Based Service and Nursing Facility Providers it uses for delivery of service, including county Participating Providers. This list is used for federal waiver reporting purposes. This list may be included in the same manner as the Provider information submitted above and must be updated according to the same schedule.
(3) The MCO will notify the STATE of terminations or additions to its contracted Care System, County Care Coordination System and Case Management System entities by April 15th of the Contract Year.
