North Carolina State Health Plan Network definition

North Carolina State Health Plan Network consists of those Practitioners and institutional health care providers that have entered into agreements with us to provide health care services to State Health Plan Members enrolled in self-funded plans offered by the State Health Plan.
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Examples of North Carolina State Health Plan Network in a sentence

  • You are required to provide us with the information required to make payment by EFT as a condition of participation in the North Carolina State Health Plan Network.

  • You further agree that you will not limit, restrict, or prohibit a Practitioner by contract or otherwise from exercising their independent medical judgment and referring State Health Plan Members to any participating provider in the North Carolina State Health Plan Network that the Practitioner chooses and deems to be in the best interest of the Plan Member when balancing quality, affordability, and the medical needs of the State Health Plan Member.

  • You agree not to use the name of the State of North Carolina, Department of State Treasurer, the State Health Plan, or the North Carolina State Health Plan Network as part of any commercial advertising or marketing products or services.

  • In the event you become contracted into the North Carolina State Health Plan Network through a third party after the effective date of this Agreement, this Agreement will automatically enter a state of dormancy for the applicable Benefit Plan(s).

  • You agree to maintain medical records on the same basis as for all other patients, and to make such information available to us and other North Carolina State Health Plan Network providers when necessary for the treatment and evaluation of State Health Plan Members or as otherwise required by our Policies and Procedures or determined by us, as permitted by law or the terms and conditions governing the State Health Plan Member’s Benefit Plan.

  • You agree to notify us of any case that would result in medical care being provided or denied to a State Health Plan Member that you believe to be inappropriate and contrary to accepted professional or ethical standards of medical practice as a result of our administrative or utilization management processes, the availability of the North Carolina State Health Plan Network, or our benefit determinations.

  • You agree that when the need arises for a State Health Plan Member to receive other professional services, hospital, or other institutional services, or supplies, outside of the scope of services that you provide, you will assist with the referral, admission and/or transfer of the State Health Plan Member locally within the North Carolina State Health Plan Network, when reasonably possible and consistent with good medical care.

  • Mailed Notices to us will be addressed as follows: Blue Cross and Blue Shield of North Carolina X.X. Xxx 0000 Xxxxxx, XX 00000 Attn: Vice President, Network Management IN WITNESS WHEREOF, the undersigned party has caused its duly authorized representative to sign and acknowledge its agreement to the terms of the North Carolina State Health Plan Network Participation Agreement, which will become effective in accordance with the foregoing terms.

Related to North Carolina State Health Plan Network

  • State health plan means the employee and retiree insurance program provided for in Article 5, Chapter 11, Title 1.

  • AT&T SOUTH CAROLINA means the AT&T owned ILEC doing business in South Carolina.

  • AT&T KENTUCKY means the AT&T owned ILEC doing business in Kentucky.

  • AT&T KANSAS means the AT&T owned ILEC doing business in Kansas.

  • AT&T OKLAHOMA means the AT&T owned ILEC doing business in Oklahoma.

  • AT&T NORTH CAROLINA means the AT&T owned ILEC doing business in North Carolina.

  • State Systems means the information technology infrastructure, including the computers, software, databases, electronic systems (including database management systems) and networks, of the State or any of its designees.

  • State highway means a state route or portion of a state

  • Georgia means the territory recognised by the international community within the state borders of Georgia, including land territory, internal waters and territorial sea, the air space above them, in respect of which Georgia exercises its sovereignty, as well as the contiguous zone, the exclusive economic zone and continental shelf adjacent to its territorial sea, in respect of which Georgia may exercise its sovereign rights in accordance with the international law;

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

  • AT&T MISSISSIPPI means the AT&T owned ILEC doing business in Mississippi.

  • North Carolina CANCELLATION section is amended as follows: We may not cancel this Agreement except for nonpayment by You or for violation of any of the terms and conditions of this Agreement.

  • AT&T MICHIGAN means the AT&T owned ILEC doing business in Michigan.

  • Interstate highway means a highway route on the interstate system as defined in and designated pursuant to Title 23 of the United States Code, prior to the effective date of this act.

  • North American Numbering Plan (NANP) means the numbering architecture in which every station in the NANP Area is identified by a unique ten (10)-digit address consisting of a three (3)-digit NPA code, a three (3)-digit central office code of the form NXX, and a four (4)-digit line number of the form XXXX.

  • Local health department means the same as that term is defined in Section 26A-1-102.

  • AT&T WISCONSIN means the AT&T owned ILEC doing business in Wisconsin.

  • Michigan state housing development authority means the public body corporate and politic created by Section 21 of the State Housing Development Authority Act of 1966, 1966 PA 346, MCL 125.1421.

  • Utah This Agreement is subject to limited regulation by the Utah Insurance Department. To file a complaint, contact the Utah Insurance Department. Coverage afforded under this Agreement is not guaranteed by the Utah Property and Casualty Guaranty Association. Proof of loss should be furnished by You to the Administrator as soon as reasonably possible. Failure to furnish such notice or proof within the time required by this Agreement does not invalidate or reduce a claim. CANCELLATION section is amended as follows: We can cancel this Agreement during the first sixty (60) days of the initial annual term by mailing to You a notice of cancellation at least thirty (30) days prior to the effective date of cancellation except that We can also cancel this Agreement during such time period for non-payment of premium by mailing You a notice of cancellation at least ten (10) days prior to the effective date of cancellation. After sixty (60) days have elapsed, We may cancel this Agreement by mailing a cancellation notice to You at least ten (10) days prior to the cancellation date for non-payment of premium and thirty (30) days prior to the cancellation date for any of the following reasons: (a) material misrepresentation, (b) substantial change in the risk assumed, unless the We should reasonably have foreseen the change or contemplated the risk when entering into the Agreement or (c) substantial breaches of contractual duties, conditions, or warranties. The notice of cancellation must be in writing to You at Your last known address and contain all of the following: (1) the Agreement number, (2) the date of notice, (3) the effective date of the cancellation and, (4) a detailed explanation of the reason for cancellation. ARBITRATION section is amended to include the following: Any matter in dispute between You and Us may be subject to arbitration as an alternative to court action pursuant to the rules of (the American Arbitration Association or other recognized arbitrator), a copy of which is available on request from Us. Any decision reached by arbitration shall be binding upon both You and Us. The arbitration award may include attorney's fees if allowed by state law and may be entered as a judgment in any court of proper jurisdiction.

  • South Caucasus/Central and South Asian (SC/CASA) state means Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Pakistan, Tajikistan, Turkmenistan, or Uzbekistan.

  • Health Department means the department of environmental quality, a city health department, a county health department, or a district health department, whichever has jurisdiction.

  • AT&T GEORGIA means the AT&T owned ILEC doing business in Georgia.

  • Community mental health center or "CMHC" means a facility offering a comprehensive array of community-based mental health services, including but not limited to, inpatient treatment, outpatient treatment, partial hospitalization, emergency care, consultation and education; and, certain services at the option of the center, including, but not limited to, prescreening, rehabilitation services, pre-care and aftercare, training programs, and research and evaluation.

  • AT&T MISSOURI means the AT&T owned ILEC doing business in Missouri.

  • State forest means land dedicated under the Forests Act as a State forest;

  • Virginia Stormwater Management Program authority or "VSMP authority" means an authority approved by the State Board after September 13, 2011, to operate a Virginia Stormwater Management Program.