Covered patient definition

Covered patient means a patient whose health care services are covered under terms of a health
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Covered patient means any person who is eligible to receive Medical Services from a Provider in accordance with, ow pursuant to, an Agreement with a Customer.
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Covered patient means a subscriber, policyholder, member, enrollee or dependent, as the case may
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Examples of Covered patient in a sentence

  • All professional medical and other services except Excluded Services, to be rendered by Provider to a Covered Patient in accordance with this Agreement, except as limited by the HCPN.

  • This request is required under a Utilization Management Program for a Covered Patient to receive Covered Services from a Provider or other health care professional or organization.

  • When required under the HCPN, the unique authorization number to be obtained from CHP or its designee by a Covered Patient's PCP, or by a Participating Provider, Practitioner, or other physician prior to admitting a Covered Patient to a hospital, or to providing certain other Covered Services to a Covered Patient.

  • Unless authorization is obtained, when coverage is by a non-Participating Provider who has not been credentialed or added to this Agreement by Amendment, claims shall be denied with no recourse against the Covered Patient.

  • DSH shall make payment on, deny, or settle each of Provider's claim submitted for Covered Services rendered to a Covered Patient, within forty-five (45) days or within the time required by applicable State, Federal law or regulation, whichever is sooner, or such other period of time as set forth in the applicable Program.

  • Provider shall not charge a Covered Patient any fees or surcharges for Covered Services rendered pursuant to this Agreement.

  • No Federal appropriated funds have been paid or will be paid by or on behalf of the Provider, to any person for influencing or attempting to influence an officer or employee of any agency, a Covered Patient, an officer, or employee of any agency, or an employee of a Covered Patient in connection with the awarding of any Contract.

  • The allocation of financial responsibility between two or more Payers of health care services, each with a legal duty to pay for or provide Covered Services to a Covered Patient at the same time.

  • If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Covered Patient, an officer or employee of any agency in connection with this Federal Contract, grant, loan, or cooperative agreement, the Provider shall complete and submit Standard Form - LLL, “Disclosure Form to Report Lobbying”, in accordance with its instructions.

  • Provider shall submit to CHP, via the appropriate claim form naming a specific Covered Patient, within one hundred twenty (120) calendar days of the rendering of such services.


More Definitions of Covered patient

Covered patient. Means an adult Patient who is subject to the control of DSH and eligible, as determined by DSH, for health care benefits managed by CHP under the HCPN.
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Related to Covered patient

  • Qualified patient means a “qualified patient” as defined in Health and Safety Code Section 11362.7(f).

  • Eligible patient means an individual who meets all of the following conditions:

  • Qualifying patient means a person who:

  • Day Patient means an Insured Person receiving Medical Services or treatments given in a medical clinic, day case procedure centre or Hospital where the Insured Person is not in Confinement.

  • Patient means a person who is undergoing medical or other treatment as an in-patient in any hospital or similar institution;

  • Outpatient means a person who is receiving care other than on an inpatient basis, such as: • in a provider’s office; • in an ambulatory surgical center or facility; • in an emergency room; or • in a clinic. .

  • Routine patient care costs means Covered Medical Expenses which are typically provided absent a clinical trial and not otherwise excluded under the Policy. Routine patient care costs do not include:

  • Mental health provider means a health care provider or a health care facility authorized by state law to provide mental health services.

  • In-patient means a person admitted to a hospital as a resident or bed- patient and who is provided at least one day's room and board by the hospital.

  • Inpatient means an Insured Person who is Confined.

  • Outpatient hospital services means preventive, diagnostic, therapeutic, observation, rehabilitation, or palliative services provided to an outpatient by or under the direction of a physician, dentist, or other practitioner by an institution that:

  • Licensed mental health professional or "LMHP" means a physician, licensed clinical psychologist, licensed professional counselor, licensed clinical social worker, licensed substance abuse treatment practitioner, licensed marriage and family therapist, certified psychiatric clinical nurse specialist, licensed behavior analyst, or licensed psychiatric/mental health nurse practitioner.

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79

  • Clinical nurse specialist means a registered nurse with relevant post-basic qualifications and 12 months’ experience working in the clinical area of his/her specified post-basic qualification, or a minimum of four years’ post-basic registration experience, including three years’ experience in the relevant specialist field and who satisfies the local criteria.

  • Outpatient status means, with respect to a covered servicemember who is a current member of the Armed Forces, the status of a member of the Armed Forces assigned to:

  • In Patient Care means treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered event.

  • Outpatient treatment means any of the nonresidential

  • Primary care physician means a physician qualified to be an attending physician according to ORS 656.005(12)(b)(A) and who is a general practitioner, family practitioner, or internal medicine practitioner.

  • Medicare Provider Agreement means an agreement entered into between CMS or other such entity administering the Medicare program on behalf of CMS, and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Inpatient care means treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered event.

  • Inpatient hospital services means any health care service provided to a patient who has been admitted to a hospital and is required to remain in that hospital overnight, but does not include any secure forensic mental health services;

  • Routine Patient Costs means all health care services that are otherwise covered under the Group Contract for the treatment of cancer or other Life-threatening Condition that is typically covered for a patient who is not enrolled in an Approved Clinical Trial.

  • Patients means both Public Patients and the Private Patients (referred by private doctors/private hospitals);