AHERF Provider, definition
Examples of AHERF Provider, in a sentence
Upon the termination of any contracts with a Third Party, AHERF may cause an AHERF Provider to provide such Covered Services.
If termination of this Agreement occurs for any reason, any Covered Individual who is an inpatient as of the end of the Continuation Period shall continue to be provided all Covered Services by an AHERF Provider, and HealthAmerica shall pay such AHERF Provider for such inpatient Covered Services in accordance with this Agreement until such Covered Individual is transferred to another facility per HealthAmerica's request or is properly discharged.
If such AHERF Provider is simultaneously discontinuing participation in a HealthAmerica or affiliated product, the parties shall cooperate in transitioning the care of such Covered Individuals to another HealthAmerica Participating Provider within a reasonable amount of time; provided, however, such transfer shall take place immediately if such discontinuance is due to quality of care or HealthAmerica determines that continuation of care may negatively affect care rendered to Covered Individuals.
AHERF shall notify HealthAmerica or other Member Company within 10 days of being notified that any AHERF Provider has or will discontinue providing Covered Services to Covered Individuals.
In performing credentialing activities with respect to AHERF Providers, HealthAmerica shall not discriminate against any AHERF Provider in comparison to any other HealthAmerica Participating Provider, and such credentialing program shall be reasonable, consistently and uniformly applied to each HealthAmerica Participating Provider, including AHERF Providers.
HealthAmerica or other Member Company shall be responsible for the determination under each Program as to whether (i) a person receiving services, supplies, products or accommodations from an AHERF Provider is a Covered Individual, and (ii) the services, supplies, products and accommodation provided to a Covered Individual are Covered Services.
If such information is not provided with respect to an AHERF Provider, the fee schedule in the standard provider agreements of the Member Companies will be used to determine payments to such provider.
The parties understand and agree that under no circumstances may an AHERF Provider provide Covered Services hereunder unless it is first accepted by HealthAmerica for participation and agrees to the Member Companies' contract terms.
AHERF shall promptly notify HealthAmerica in writing of any such termination, and upon such notice, such AHERF Provider will cease to be an AHERF Provider for purposes of the risk reconciliation provisions of this Agreement as of the last day of the month in which the effective date of the termination occurs.
In the event that AHERF fails to notify a Member Company of the fee schedule under which a AHERF Provider is to be paid, a Member Company shall pay such provider under the Member Company's then current applicable fee schedule.