Medical Provider Network. (“MPN”) means any entity or group of providers approved as a Medical Provider Network by the Administrative Director pursuant to Labor Code sections 4616 to 4616.7 and this article.
Medical Provider Network or “MPN” means a select entity or group of providers, approved by the Administrative Director, Division of Workers’ Compensation, Department of Industrial Relations, State of California, to treat WC injuries on behalf of a self insured employer or insurance carrier.
Medical Provider Network. Full PPO Network This Plan uses a specific network of Health Care Providers, called the Full PPO provider network. Providers in this network are called Participating Providers. You pay less for Covered Services when you use a Participating Provider than when you use a Non-Participating Provider. You can find Participating Providers in this network at xxxxxxxxxxxx.xxx. Pharmacy Network: Rx Ultra Drug Formulary: Plus Formulary Calendar Year Deductibles (CYD)2 A Calendar Year Deductible (CYD) is the amount a Member pays each Calendar Year before Blue Shield pays for Covered Services under the Plan. Blue Shield pays for some Covered Services before the Calendar Year Deductible is met, as noted in the Benefits chart below. Blue Shield of California is an independent member of the Blue Shield Association When using a Participating3 or Non-Participating4 Provider Calendar Year medical and pharmacy Deductible Individual coverage $5,500 This Plan combines medical and pharmacy De- ductibles into one Calendar Year Deductible Calendar Year Out-of-Pocket Maximum5 Family Coverage $5,500: individual $11,000: Family An Out-of-Pocket Maximum is the most a Member will pay for Covered Services each Calendar Year. Any exceptions are listed in the Notes sec- tion at the end of this Summary of Benefits. When using a Partici- pating Provider3 When using a Non-Par- ticipating Provider4 Individual coverage $6,650 Family Coverage $6,650: individual $13,300: Family $10,000 $10,000: individual $20,000: Family A46397 (01/20) 9 No Annual or Lifetime Dollar Limit Under this Plan there is no annual or life- time dollar limit on the amount Blue Shield will pay for Covered Services. Benefits6 Your payment When using a Participating Provider3 CYD2 applies When using a Non-Participating Provider4 CYD2 applies Preventive Health Services7 $0 $0 Not covered $0 Preventive Health Services California Prenatal Screening Program Physician services Primary care office visit 20% 50% Specialist care office visit 20% 50% Physician home visit 20% 50% Physician or surgeon services in an outpatient facility 20% 50% Physician or surgeon services in an inpatient facility 20% 50% Other professional services Other practitioner office visit Includes nurse practitioners, physician assistants, and therapists. Acupuncture services Up to 20 visits per Member, per Calendar Year. Chiropractic services Up to 20 visits per Member, per Calendar Year. Teladoc consultation Family planning Counseling,...
Examples of Medical Provider Network in a sentence
Otherwise, the County reserves the right to provide a list of physicians within the County’s Medical Provider Network from which the Association member may select a treating physician for his/her work-related injury/illness.
More Definitions of Medical Provider Network
Medical Provider Network has the meaning set forth in the definition of “Healthcare Management Business.”
Medical Provider Network means the network of healthcare specialist, medical providers, and hospitals (each a “Network Provider”) that have entered into Preferred Provider Agreements (each a “Provider Agreement”) with Seller or the Company to provide medical services to Claimants. The Provider Agreement induces Network Providers to provide quality medical care at a competitive price in exchange for the participating in the preferred Medical Provider Network. The definition of “Healthcare Management Business” shall include the subcontracting arrangements with other Healthcare Management Businesses in order to offer broader coverage for the Medical Provider Network. The Healthcare Management Business also includes the credentials, re-credentials, and the careful application review process to ensure that the Network Provider is committed to provide medically appropriate care, and to direct valid insured Claimants to Network Providers.