Network Providers means those entities and individuals who provide covered health care services or supplies to an insured or a member pursuant to a contract with a network plan to act as a participating provider.
Network Providers or “Contracted Provider” or “Provider” shall mean the pool of contracted behavioral health professionals, substance abuse professionals, or Employee Assistance Professionals who have been approved by DES as a result of an RFQ.
Network Providers means those pharmacies that provide covered health care services or supplies to an insured or a member pursuant to a contract with a network plan to act as a participating provider;
Examples of Network Providers in a sentence
Network Providers Non-network Providers (*) Preauthorization may be required for this service.
When requested or indicated, second opinions are provided by Network Providers and are covered with Preauthorization, or when obtained from a KFHPWA-designated Specialist.
Members are entitled to Covered Services only at Network Facilities and from Network Providers, except for Emergency services and care pursuant to a Preauthorization.
Enrollees are entitled to Covered Services only at Network Facilities and from Network Providers, except for Emergency services and care pursuant to a Preauthorization.
Except in cases of Emergency, services are available only from Network Providers.
More Definitions of Network Providers
Network Providers means health care professionals, including but not limited to, primary care physicians, specialists, ancillary providers, hospitals, clinics, pharmacies, rehabilitation facilities and other inpatient and outpatient health care facilities that have directly or indirectly contracted to participate in a Network, and which are duly licensed and/or certified as required by applicable law.
Network Providers 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.
Network Providers means the providers of debit transaction network services under the Program mutually agreed upon by Retailer and Bank after requesting and reviewing *** Confidential material redacted and filed separately with the Commission the service proposals and subject to change upon the mutual agreement of Bank and Retailer, and which shall include, as of the Commencement Date, Visa and Interlink.
Network Providers means those pharmacists and pharmacies who provide covered health-care
Network Providers are providers that have agreed to participate in the Blue Network, and to accept BlueCross’s applicable pre-negotiated payment allowance for certain Covered Services as payment in full, and therefore should not bill the Members for any amount in excess of the payment allowance for such service(s). The pre-negotiated payment will be based upon charges for Covered Services or upon an alternative method of payment, including per diem amounts, percent of charges, global case rate and fee schedule arrangements, and may be further reduced by other contractual reductions, adjustments, discounts or offsets based on BlueCross’s agreements with Network Providers. Network Providers will file Members’ claims with BlueCross, and BlueCross will make payment directly to Network Providers.
5.1.1. In the unlikely event of a systems failure at BlueCross (“Outage”) rendering it temporarily impossible to determine which Network Provider rendered services during a specific time period while the Agreement is in force, BlueCross will make estimated payments to Network Providers. This estimate will be based on past service to BlueCross Members, and will be proportionately divided among Employer and other Groups which BlueCross insures or to which BlueCross provides administrative and claims processing service. When the capability to determine which Network Providers did provide services during the Outage is restored, BlueCross will adjudicate the claims submitted on behalf of Members, and notify Employer of any adjustments necessary to Employer’s claims processing funding.
Network Providers means the Providers with whom Contractor has a contract in place under which the Provider meets Contractor’s credentialing criteria and provides Covered Services to Members at Contractor’s contracted rates, terms and conditions.
Network Providers means the communications network operators (including without limitation British Telecom plc) providing connectivity over which the Services are supplied;