Group Provider definition

Group Provider means an organization that provides specialty mental health services through two or more individual providers. Group providers include entities such as independent practice associations, hospital outpatient departments, health care service plans, and clinics.
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Group Provider means an organization that provides rehabilitative mental health services through two or more individual providers, such as independent practice associations. Group providers do not include hospital-based outpatient providers, county owned and operated providers, private organizational providers, or administrative service organizations.
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Group Provider means a provider as defined in Title 9, CCR, Section 1810.218.2.
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Examples of Group Provider in a sentence

  • In the event that Government Officials or Blue Shield find any deficiencies in such facilities or records, Group, or Group Provider, as applicable, shall have thirty (30) days to substantially correct such deficiencies which are identified by such Government Officials or Blue Shield.

  • In the event Group terminates a contract with a Group Provider for deficiencies in the quality of care provider, Group shall give notice of the action to the appropriate licensing and disciplinary bodies.

  • In all cases where the Group and/or a Group Provider has made a determination regarding the Medical Necessity of a medical service requested or provided to a Member, Group shall, upon the request of Blue Shield, assist Blue Shield in determining the Medical Necessity of such service and provide relevant medical records to Blue Shield and participate in any grievance, arbitration, and/or other proceedings in which such Medical Necessity determination is an issue.

  • Group shall promptly notify Blue Shield of receipt of any claims, including professional liability claims filed or asserted by a Member against Group or a Group Provider.

  • Group and/or each Group Provider shall provide to Blue Shield, on request, credentialing information, in such form as reasonably required by Blue Shield.

  • In the event a Group Provider terminates his/her relationship with a Member, Group shall assist the Member in selecting another Group Provider for the provision of Capitated Professional Services.

  • In the event that a subcontract with a Group Provider is denied, suspended or terminated, Group shall provide the provider with written notice of the reason for the action as required by state and federal law, including any standards and profiling data Group used to evaluate the provider, the number and mix of similar health care providers that Group needs (if applicable), and notice of the provider’s right to appeal the action, including notice of the process and timing to request a hearing.

  • Group further agrees that the procedures set forth in this Paragraph 11.1 may be used in the event that a Group Provider has a dispute with Group.

  • This Agreement is solely for the benefit of the Company Group, Provider and any Affiliate of Provider providing Services hereunder and is not intended to confer upon any other Person, except for any Indemnified Party under Article 5.

  • If Blue Shield terminates a Group Provider without cause, Blue Shield must provide Group at least sixty (60) days notice.


More Definitions of Group Provider

Group Provider means a Provider, as defined herein, with two or more physicians or other professionals practicing together as a proprietorship, partnership, PC, PLLC, PLLP, PA or any combination of the foregoing. References herein to “Provider” shall mean the Group Provider and each physician or other professional now or hereafter practicing and billing as part of the group, and all practice sites now existing or hereafter added by Group Provider as permitted hereunder.
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Group Provider is a physician (“Group Physician”), ancillary provider, or other provider with whom Group has entered into a contract for the provision of Capitated Professional Services.
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Group Provider means a provider as Title 9, CCR, Section 1810.218.2.
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Group Provider means a Participating Physician who has been selected by and/or assigned Enrollees to provide Primary Care Covered Services, Billaboves, and coordinating all referral Covered Services.
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Group Provider means a duly licensed specialist or general dentist who practices with Provider as an employee, partner, shareholder, or contractor.
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Related to Group Provider

  • 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.

  • Network Provider means a provider of health care, or a group of providers of health care, which has entered into a written agreement with the issuer to provide benefits insured under a Medicare Select policy.

  • Provider is any individual or company that provides professional or technical services.

  • 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;

  • Non-Network Provider means any hospital, day care centre or other provider that is not part of the network.

  • Data Provider means a Participant that is registered to provide information to GS1 South Africa for use through the Verified by GS1 Services.

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

  • Education service provider means an education management organization, school

  • financial service provider means a person engaged in the business of providing financial services in terms of authorisation issued or registration granted by a financial sector regulator;

  • Medical provider means a medical service provider, a hospital, a medical clinic, or a vendor of medical services.

  • Financial Services Provider means any Lender and any other provider of financial services or products;

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

  • Wireless provider means a wireless infrastructure provider or a wireless services provider.

  • 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.

  • 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.

  • Continuing education provider or “CE provider” means an individual or entity that is approved to offer continuing education courses pursuant to [insert reference in State law or regulations governing producer continuing education course approval].

  • Content Provider means any video programming provider of copyrighted works for transmission to Licensed Products and the copyright owners of such work.

  • Basic generation service provider or "provider" means a

  • Qualified medical provider means the same as that term is defined in Section 26-61a-102.

  • Individual provider means an individual provider as defined

  • Ambulance service provider means Latrobe Health Services recognises the following providers for the purposes of paying benefits:

  • Network Service Provider means an intermediary;

  • Wireless services provider means a person who provides wireless services.

  • Provider Service means a Provider’s hosted online services (if any) as described in the Solution Exhibit which is provided by Provider to Customers located in the Territory through remote access via the Internet as part of the BPO Service. A Provider Platform Application shall be considered a Provider Service.

  • Information Service Provider A provider of Information Service. Information Service Provider includes, but is not limited to, Internet Service Providers (ISPs).

  • Technology provider means a person who: