Selection of Providers. Selection of service provider contractors shall be fairly and objectively based upon county procurement procedures and guidelines and applicable state and federal laws or regulations related to service procurement. As an integral part of the service provider selection process, the Grantee shall use procedures to assess prospective contractors’ strengths, weaknesses, and past performance. The Grantee shall use data relating to the performance of private service providers in prior contracts as a factor in selecting providers to receive contracts.
Selection of Providers. A Member covered under this Agreement has the option of choosing where and to whom to go for Covered Services. A Member may utilize a Network Provider or an Out-of-Network Provider. However, Covered Services received from a Network Provider are usually provided at a higher level of benefits than those received from an Out-of-Network Provider and certain non-emergency Services may only be covered when rendered by a Network Provider. Such Services are specified in the Subsection V. COVERED SERVICES of SECTION SB - SCHEDULE OF BENEFITS of this Agreement. Please note that benefits for Telemedicine Services are only provided when such Services are rendered by a Telemedicine Provider who is a Network Provider.
Selection of Providers. The contractor shall obtain input from the MTF Commanders regarding the requirements or needs of the Commanders for internal resource sharing providers. Based upon this input, the contractor shall select the resource sharing providers without any further involvement of the Government in the selection process, except for the privileging of the providers by the MTF Commander after the selection has been made.
Selection of Providers. You and/or Your family members, guardians, Physicians, and other health care providers are solely responsible for making decisions regarding the selections of Physicians, Hospitals, or other health care or health Service Providers and regarding any medical Treatment decisions for or on Your behalf. Neither the Company nor the Administrator has the right, obligation, or authority to make such decisions.
Selection of Providers. A Member covered under this Agreement must receive Covered Services from Network Providers, except in the following circumstances:
1. for Emergency Care Services and Emergency Ambulance Services;
2. when a Member receives preauthorization to receive Services from an Out-of-Network Provider; 3. as set forth in the SPECIAL CIRCUMSTANCES RELATED TO OUT-OF- NETWORK SERVICES Subsection of this Section; 4. as required by law; or
Selection of Providers. DVHA must implement written policies and procedures for the selection and retention of network providers, that include, at a minimum, the requirements of 42 CFR 438.214.
(i) DVHA’s provider selection policies and procedures must not discriminate against particular providers that serve high-risk populations or specialize in conditions that require costly treatment.
(ii) DVHA is required to give written notice of the reason for its decision when it declines to include individual or groups of providers in its provider network.
(iii) DVHA must comply with any additional provider selection requirements established by AHS.
Selection of Providers. Although Clearview employs medical directors, Resident may choose an alternate physician, dentist or podiatrist at any time by giving Clearview adequate advance notice. Such providers shall comply with applicable Clearview policies, procedures and all rules of local, state and federal governments. If providers do not comply with such requirements, Clearview will notify Resident and Resident shall be required to select an alternate provider.
Selection of Providers. A Participant covered under the Agreement has the option of choosing where and to whom to go for Covered Services. Covered Services may be rendered by a Preferred Provider, a Non-Preferred Participating Provider, or a Non- Preferred Provider.
Selection of Providers. Among the qualified providers, NRK will select a minimum of five providers who will be invited to participate in the competition and thus receive an invitation to tender. Selection will be made based on an overall assessment of the providers, to determine which, to the greatest extent meet the qualification requirements in section 2.3 – 2.4 above, where the technical and professional qualifications will be emphasized.
Selection of Providers. Members covered under this Agreement must receive covered services from network providers, except in the following circumstances: 1) for Emergency Care Services; 2) when a member receives preauthorization to receive services from a provider outside the network; 3) as provided in Section B.2. Transition/Continuity of Care; or 4) as otherwise provided in the Agreement. The provider directory, which lists health care providers who participate in the network, includes their addresses and telephone numbers and indicates whether a PCP is accepting new patients. However, members should always contact a provider to verify whether that provider is still participating in the network and accepting new patients.
