Enrolled provider definition

Enrolled provider means those professional entities or facilities who are registered, certified, or licensed, as appropriate, and who are also enrolled by DMAS to render services to eligible waiver individuals and receive reimbursement for such services.
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Enrolled provider means a provider agency or independent provider that the department has determined is eligible to provide Home and Community Based 1915 (c) waiver services and receive payment therefore;
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Enrolled provider means a primary care provider who has agreed to provide data to the project, implement long term practice changes to increase the number and/or quality of adolescent well visits and has engaged in at least one consultation session with a practice consultant.
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Examples of Enrolled provider in a sentence

  • Failure to notify a provider of the network contracting decision within five (5) Business Days of verification of the provider’s status as a Medicaid Enrolled provider.

  • Enrolled provider requirements will be published and placed on Missouri Medicaid Audit and Compliance (MMAC) website.

  • Enrolled provider data and active service authorization data will also be shared.

  • The PHP shall provide written notice of network contracting decisions to providers within five (5) business days of determination of the provider’s status as an active Medicaid Enrolled provider.

  • Because the pathologies associated with DS are the products of elevated gene expression in every cell throughout development, it has often been assumed to be too complex for meaningful intervention.


More Definitions of Enrolled provider

Enrolled provider means an entity that is either licensed or certified by the appropriate state agency that also meets the standards and requirements set forth by DMAS and has a current, signed provider participation agreement with DMAS.
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Enrolled provider means a hospital or health care practitioner who is actively registered with the Authority pursuant to OAR 943-120-0320.
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Enrolled provider means a personal support worker who has completed the provider enrollment process, has been issued a provider number, and is authorized by the Department to receive payment for providing in-home services to an individual.
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Enrolled provider means a licensee who has entered into a service agreement with a local office. [(8)] (11) "Facility" means the physical plant in which a licensee provides assisted living services.
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Enrolled provider means a New Hampshire LEA or school administrative unit that has agreed to participate in the medical assistance program pursuant to this partese rules.
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Enrolled provider means a provider of health care
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Related to Enrolled provider

  • Qualified provider means a person or business experienced in the design, implementation, and installation of energy conservation measures. A qualified provider to whom the contract is awarded shall give a sufficient bond to the municipality for its faithful performance.

  • Designated provider means a person who:

  • Approved provider means a provider of services registered with the appropriate association or organization to render services to a member and approved by Latrobe to render services to its members.

  • 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.

  • Registered Provider means a registered provider of social housing (see section 80 of the Housing and Regeneration Act 2008);

  • Recognised Provider (Approved Provider) means a provider of services registered with the appropriate association or organization to render services to a member and approved Latrobe to render services to its members.

  • New Provider means any replacement service provider or providers engaged to provide the Services (or part thereof) or substantially similar services or the Authority itself where the Services or substantially similar services or part thereof continue to be provided by the Authority after partial termination, termination or expiry of this Contract;

  • Preferred Provider or “Network Provider” means a doctor, hospital, medical facility or other provider of health care which is included in a network which has been designated by the Fund to render health related services to Fund participants.

  • Participating Provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • Non-Participating Orthotic Provider means an Orthotic Provider who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Orthotic Provider means an Orthotic Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Related provider trust means a titling trust or other trust established by a licensed viatical settlement provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. The trust shall have a written agreement with the licensed viatical settlement provider under which the licensed viatical settlement provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files related to viatical settlement transactions available to the commissioner as if those records and files were maintained directly by the licensed viatical settlement provider.

  • Non-Participating Prosthetic Provider means a Prosthetic Provider who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Non-Participating Provider means an Administrator Hospital or Professional Provider which does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or a facility which has not been designated by the Claim Administrator as a Participating Provider.

  • Participating Prescription Drug Provider means an independent retail Pharmacy, chain of retail Pharmacies, mail-order Pharmacy or specialty drug Pharmacy which has entered into an agreement to provide pharmaceutical services to participants in the benefit program. A retail Participating Pharmacy may or may not be a select Participating Pharmacy as that term is used in the Vaccinations Obtained Through Participating Pharmacies section.

  • Participating Prosthetic Provider means a Prosthetic Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

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

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

  • Third Party Provider means licensors, subcontractors and suppliers of BNYM furnishing the Third Party Products.

  • Nonparticipating provider means a person, health care provider, practitioner, facility, or entity, acting within their scope of practice, that does not have a written contract to participate in a managed health care system's provider network, but provides health care services to enrollees of programs authorized under this chapter or other applicable law whose health care services are provided by the managed health care system.

  • Service Subcontract means a subcontract primarily for the furnishing of services, to or for a recipient of Assistance, except where services are incidental to the delivery of products, equipment or commodities. A contract for the purchase or lease of goods, products, equipment, supplies or other property is not a “service subcontract” for the purposes of this definition.

  • Preferred Provider Organization (PPO) means a health insurance issuer's or carrier's insurance policy that offers covered health care services provided by a network of providers who are contracted with the issuer or carrier (“in-network”) and providers who are not part of the provider network (“out-of-network”).

  • Covered Program means an education program or activity over which the College exercised substantial control over both the Respondent and the context in which the sexual harassment occurred.

  • Hub Provider means an entity that (i) provides Common Channel Signaling (SS7) connectivity between the networks of service providers that are not directly connected to each other; or (ii) provides third party database services such as LIDB. The SS7 messages received by Hub Providers are accepted or rejected by the Hub Provider depending on whether a contractual arrangement exists between the Hub Provider and the message originator (sender) and whether the message originator has contracted for the type of SS7 messages being submitted for transmission to the Hub Provider.