Managed care health insurance plan definition

Managed care health insurance plan means an arrangement for the delivery of health care in
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Managed care health insurance plan or "MCHIP" means an arrangement for the delivery of health
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Managed care health insurance plan or “MCHIP” means an arrangement for the delivery of health care in which Guardian undertakes to provide, arrange for, pay for, or reimburse any of the costs of health care services for a covered person on a prepaid or insured basis which: i) contains one or more incentive arrangements, including any credentialing requirements intended to influence the cost or level of health care services between the health carrier and one or more providers with respect to the delivery of health care services; and ii) requires or creates benefit payment differential incentives for covered persons to use providers that are directly or indirectly managed, owned, under contract with or employed by the health carrier. For the purposes of this definition, the prohibition of balance billing by a provider shall not be deemed a benefit payment differential incentive for covered persons to use providers who are directly or indirectly managed, owned, under contract with or employed by the health carrier. A single managed care health insurance plan may encompass multiple types of benefit payment differentials; however, a single managed care health insurance plan shall encompass only one provider network or set of provider networks.
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More Definitions of Managed care health insurance plan

Managed care health insurance plan or “MCHIP” means an arrangement for the delivery of health care in which a health carrier undertakes to provide, arrange for, pay for, or reimburse any of the costs of health care services for a covered person on a prepaid or insured basis which (i) contains one or more incentive arrangements, including any credentialing requirements intended to influence the cost or level of health care services between the health carrier and one or more providers with respect to the delivery of health care services; and (ii) requires or creates benefit payment differential incentives for covered persons to use providers that are directly or indirectly managed, owned, under contract with or employed by the health carrier. Any health maintenance organization as defined in § 38.2-4300
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Managed care health insurance plan or ΑMCHIP≅ means an arrangement for the delivery of health care in which a health carrier as defined in ∍38.2-5800 of the Code of Virginia undertakes to provide, arrange for, pay for, or reimburse any of the costs of health care services for a covered person on a prepaid or insured basis which (i) contains one or more incentive arrangements, including any credentialing requirements intended to influence the cost or level of health care services between the health carrier and one or more providers with respect to the delivery of health care services and (ii) requires or creates benefit payment differential incentives for covered persons to use providers that are directly or indirectly managed, owned, under contract with or employed by the health carrier. Any health maintenance organization as defined in ∍38.2-4300 of the Code of Virginia or health carrier that offers preferred provider contracts or policies as defined in ∍38.2-3407 of the Code of Virginia or preferred provider subscription contracts as defined in ∍38.2-4209 of the Code of Virginia shall be deemed to be offering one or more managed care health insurance plans. For the purposes of this definition, the prohibition of balance billing by a provider shall not be deemed a benefit payment
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Managed care health insurance plan means an arrangement in which a health carrier undertakes
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Managed care health insurance plan or "MCHIP" means an arrangement in which a health carrier 704 undertakes to provide, arrange for, pay for, or reimburse any of the costs of health care services for a 705 covered person on a prepaid or insured basis, and either requires a covered person to use or creates 706 incentives for an enrollee or member to use providers who are directly or indirectly managed, owned, 707 under contract with or employed by the health carrier.
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Related to Managed care health insurance plan

  • Health insurance carrier or "carrier" means any entity subject to the insurance

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Health plan or "health benefit plan" means any policy,

  • Accident and health insurance means contracts that incorporate morbidity risk and provide protection against economic loss resulting from accident, sickness, or medical conditions and as may be specified in the valuation manual.

  • HIPAA means the Health Insurance Portability and Accountability Act of 1996, as amended.

  • Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Basic health plan means the plan described under chapter

  • Group health benefit plan means any health care plan, subscription contract, evidence of

  • Health benefits plan means a benefits plan which pays or