Affiliated provider definition

Affiliated provider means a health professional, licensed hospital, licensed pharmacy, or any other institution, organization, or person that has entered into a participating provider contract, directly or indirectly, with a health maintenance organization to render 1 or more health services to an enrollee. Affiliated provider includes a person described in this subdivision that has entered into a written arrangement with another person, including, but not limited to, a physician hospital organization or physician organization, that contracts directly with a health maintenance organization.

Affiliated provider means any provider that is employed by or has entered into a contractual

Affiliated provider means a provider that is: (a) employed by a

Examples of Affiliated provider in a sentence

• July 1, 2016.Popular name: Act 218Popular name: HMO500.3529 Affiliated provider contracts; collection of payments from enrollees; contract provisions; waiver of requirement under subsection (2); contract format; evidence of sufficient number of providers.Sec.

• Definitions.The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:[ "Affiliated provider" means a provider that is employed by or has entered into a contractual agreement either directly or indirectly with a health maintenance organization to provide health care services to members of the health maintenance organization.

• As used in this chapter:16 (a) "Affiliated provider" means a health professional,17 licensed hospital, licensed pharmacy, or any other institution,18 organization, or person that has entered into a participating19 provider contract, directly or indirectly, with a health20 maintenance organization to render 1 or more health services to an21 enrollee.

• Affiliated provider includes a person described in this22 subdivision that has entered into a written arrangement with23 another person, including, but not limited to, a physician hospital24 organization or physician organization, that contracts directly25 with a health maintenance organization.26 (b) "Basic health services" means medically necessary health27 services that health maintenance organizations must offer to large28 employers in at least 1 health maintenance contract.

• Affiliated provider - A health care provider that is part of a network, usually having a formal arrangement to provide services.

More Definitions of Affiliated provider

Affiliated provider means a health professional, a Hospital, licensed pharmacy, or any other institution, organization, or person who has a contract with the Plan or an IPA to render one (1) or more health maintenance services to Members.

Affiliated provider means a provider that is: (A) Employed by a hospital or health system, (B) under a professional services agreement with a hospital or health system that permits such hospital or health system to bill on behalf of such provider, or (C) a clinical faculty member of a medical school, as defined in section 33-182aa, that is affiliated with a hospital or health system in a manner that permits such hospital or health system to bill on behalf of such clinical faculty member;

Affiliated provider means any provider that is employed by or has entered into a contractual 1271 agreement either directly or indirectly with a health carrier to provide health care services to members 1272 of a managed care health insurance plan for which the health carrier is responsible under this chapter. 1273 "Basic health care services" means emergency services, inpatient hospital and physician care, 1274 outpatient medical services, laboratory and radiological services, and preventive health services. "Basic 1275 health care services" shall also mean limited treatment of mental illness and substance abuse as set 1276 forth in § 38.2-3412.1 or in the case of a health maintenance organization shall be in accordance with 1277 such minimum standards set by the Commission which shall not exceed the level of services mandated 1278 for insurance carriers pursuant to Chapter 34 (§ 38.2-3400 et seq.).

Affiliated provider is any Service Provider that is an Affiliate of Provider.

Affiliated provider means a pharmacy or durable medical equipment provider that directly, or indirectly through one or more intermediaries, controls, is controlled by, or is under common control with a health benefit plan issuer or pharmacy benefit manager.

Affiliated provider means a licensed EMS individual's secondary employer or employers.

Affiliated provider means a health professional, a Hospital, licensed pharmacy, or any other institution, or person who has a contract with the Plan.