Managed care provider definition

Managed care provider means an organization:
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Managed care provider or "MCP" means an organization:
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Managed care provider means an entity with which the Program has directly contracted to provide or arrange with Participating Providers for the provision, coordination, continuity and monitoring of Covered Services to Members. Also known as the “Coordinated Provider Entity” or “CPE”.
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Examples of Managed care provider in a sentence

  • The report submission must comply with the Managed Care Provider Network Data Dictionary.

  • The Managed Care Provider Detail must display all current fields plus: health plan name, provider specialty, provider county, number of MC+ enrollees accepted (panel limit), established patient indicator, and last update field.

  • ODJFS will verify the approvability of the submission and process this information using the ODJFS Managed Care Provider Network (MCPN), maintained by the Managed Care Enrollment Center (MCEC), or other designated process.


More Definitions of Managed care provider

Managed care provider any physician, nurse practitioner, physician’s assistant or other licensed healthcare professional of any Managed Care Company or any Group Member. “Mandatory Prepayment Date”: as defined in Section 2.12(e). “Material Adverse Effect”: (a) a material adverse change in, or a material adverse effect on, the operations, business, assets, properties, liabilities (actual or contingent) or condition (financial or otherwise) of Holdings and its Subsidiaries, taken as a whole; (b) a material impairment in the perfection or priority of the Administrative Agent’s Lien on the Collateral or a material adverse effect upon the legality, validity, binding effect or enforceability against the Loan Parties of any Loan Document; or (c) a material adverse effect on the ability of the Loan Parties to perform their obligations (including their payment obligations) under the Loan Documents. “Materials of Environmental Concern”: any substance, material or waste that is defined, regulated, governed or otherwise characterized under any Environmental Law as hazardous or toxic or as a pollutant or contaminant (or by words of similar meaning and regulatory effect), any petroleum or petroleum products, asbestos, polychlorinated biphenyls, urea-formaldehyde insulation, toxic molds or fungus, and radioactive substances. “Medicaid”: the medical assistance programs administered by state agencies and approved by
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Managed care provider means any physician, nurse practitioner, physician’s assistant or other licensed healthcare professional of Holdings or any of its Subsidiaries or any Managed Care Company.
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Managed care provider means either a primary care provider or a health maintenance organization.
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Related to Managed care provider

  • Child care provider means a provider who receives compensation for providing child care services on a regular basis, including an ‘eligible child care provider’ (as defined in section 658P of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858n)).

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • Primary care provider means a participating provider who supervises, coordinates, or provides initial care or continuing care to a covered person, and who may be required by the health carrier to initiate a referral for specialty care and maintain supervision of health care services rendered to the covered person.

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

  • Health care provider or "provider" means:

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Care provider means a duly qualified or licensed home health aide or homemaker, personal care aide or nurse provided through a licensed home health care agency or referred by a licensed referral agency or licensed nurses registry.

  • Managed care means a system that provides the coordinated delivery of services and supports that are necessary and appropriate, delivered in the least restrictive settings and in the least intrusive manner. Managed care seeks to balance three factors:

  • Family child care provider means a person who: (a) Provides

  • Emergency medical care provider means an individual who has been trained to provide emergency and nonemergency medical care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic, paramedic specialist or other certification levels recognized by the department before 1984 and who has been issued a certificate by the department.

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • Indian Health Care Provider means a health care program operated by the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian Organization (otherwise known as an I/T/U) as those terms are defined in § 4 of the Indian Health Care Improvement Act (25 USC § 1603). Indian Health Care Provider includes a 638 Facility and provision of Indian Health Service Contract Health Services (IHS CHS).

  • Child Care Program means a person or business that offers child care.

  • Healthcare provider means any person or entity including a hospital, physician or a network of providers that provided healthcare services and/or treatments to or on behalf of a Settlement Program Claimant.

  • ACS means “asset-controlling supplier” as that term is defined in the Cap and Trade Regulations.

  • HMO means any health maintenance organization, managed care organization, any Person doing business as a health maintenance organization or managed care organization, or any Person required to qualify or be licensed as a health maintenance organization or managed care organization under applicable federal or state law (including, without limitation, HMO Regulations).

  • Licensed health care professional means a person who possesses a professional medical license that is valid in Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner (NP), licensed practical nurse (LPN), medical doctor (MD), osteopathic physician (DO), respiratory therapist (RT), physical therapist (PT), physician assistant (PA), or occupational therapist (OT).