Non-Network Provider definition

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

Non-Network Provider means any hospital that is not part of the network.

Non-Network Provider means a practitioner or approved facility that has not entered into an agreement with OptumHealth to provide covered services to you.

Examples of Non-Network Provider in a sentence

• The Deductible Amount will apply to Covered Services received from a Non-Network Provider, unless otherwise stated below.

• Additional screenings or screenings by a Non-Network Provider are covered subject to contract benefits.

• The Contractor shall provide for a second opinion from a qualified Network Provider, or arrange for the Enrollee to obtain one from a Non-Network Provider, at no cost to the Enrollee.

• A Provider may be contracted with the Claims Administrator when providing services at one location, and may be considered a Non-Network Provider when rendering services from another location.

• In the instance of an Emergency, the fact that a Non-Network Provider prescribes, orders, recommends or approves the care, the level of care, or the length of time care is to be received, does not make the services Medically Necessary and Appropriate.

More Definitions of Non-Network Provider

Non-Network Provider means an any individual, corporate entity, or any other organization that is engaged in the delivery of health care services, is legally authorized to do so by the State in which it delivers the services and who does not have a contract or any other pre-arranged payment or employment agreement with the Contractor.

Non-Network Provider means a medical practitioner, provider facility, or other provider who is NOT identified in the most current list for the network shown on your identification card. Services received from a non-network provider are not covered, except for:

Non-Network Provider means any physician, dentist, optometrist, anesthesiologist, hospital, x-ray, laboratory and ambulance service, or other person who:

Non-Network Provider means an any individual, corporate entity, or any other organization that is engaged in the delivery of health care services, is legally authorized to do so by the State in which it delivers the services and who does not have a contract or any other pre-arranged payment or employment agreement with the Contractor. This was formerly referred to as Non- Participating Provider Notice of Adverse Benefit Determination means written notification to an Enrollee and written or verbal notification to a Provider when applicable, of an Adverse Benefit Determination that will be taken by the Contractor. This is formerly referred to as a Notice of Action. Notice of Appeal Resolution means written notification to an Enrollee, and a Provider when applicable, of the Contractor’s resolution of an Appeal. NQF means the National Quality Forum. Office of Recovery Services (ORS) means an agency within the Department of Human Services.

Non-Network Provider means any individual, corporate entity, or any other organization that is engaged in the delivery of health care services, is legally authorized to do so by the State in which it delivers the services and who does not have a contract or any other pre-arranged payment or employment agreement with the Contractor. Notice of Adverse Benefit Determination means written notification to an Enrollee and written or verbal notification to a Provider when applicable, of an Adverse Benefit Determination that will be taken by the Contractor. Notice of Appeal Resolution means written notification to an Enrollee, and a Provider when applicable, of the Contractor’s resolution of an Appeal. NQF means the National Quality Forum. Office of Recovery Services (ORS) means an agency within the Department of Human Services.

Non-Network Provider means any hospital, day care centre or other provider that is not part of thenetwork

Non-Network Provider means a provider not under contract as a Network Provider.