Out of Network Care definition

Out of Network Care means services provided to an Enrollee by non-Network Providers within the geographic area served by the MCO.
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Out of Network Care or "out-of-network services" means services provided by an out-of-network provider.
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Out of Network Care means care provided by an out-of-network provider. Typically, the Plan pays less when you receive treatment from an out-of-network provider than when you receive treatment from an in- network, or preferred provider.
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Examples of Out of Network Care in a sentence

  • Out of Network Care Covered?1Yes, but patient pays more for out-of-network care.3. Areas of Colorado Where Plan is AvailablePlan is available throughout Colorado.

  • The maximum total of In-Network and Out- of- Network Care available for designated health services in the Summary of Benefits and Coverage.

  • Out of Network Care: The Primary Care Provider (PCP) determines the need for his or her members to receive a referral to an out of network provider.

  • This Agreement is not assignable without the written consent of all other parties hereto.

Related to Out of Network Care

  • Out-of-network means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

  • Out-of-network provider means any provider that is not directly or indirectly employed by or does not have a provider agreement with the contractor or any of its subcontractors pursuant to the contract between the department and the contractor.

  • Support Services means support in relation to the use of, and the identification and resolution of errors in, the Hosted Services, but shall not include the provision of training services;

  • BT Network means the communications network owned or leased by BT and used to provide a Service.

  • Maintenance and Support Services means the services provided by Contractor under Appendix F.

  • Merchant Network Upgrades means additions to, or modifications or replacements of, physical facilities of the Interconnected Transmission Owner that, on the date of the pertinent Transmission Interconnection Customer’s Upgrade Request, are part of the Transmission System or are included in the Regional Transmission Expansion Plan.

  • Network Resource means any designated generating resource owned, purchased, or leased by a Network Customer under the Network Integration Transmission Service Tariff. Network Resources do not include any resource, or any portion thereof, that is committed for sale to third parties or otherwise cannot be called upon to meet the Network Customer’s Network Load on a non-interruptible basis, except for purposes of fulfilling obligations under a reserve sharing program.

  • Technical Support Services means the technical support and maintenance Services provided by us according to our then-current technical support policy and procedure listed at xxxxxxxxxxxxx.xxx (“Technical Support Policy”) when the Services are purchased.

  • Hospice Care means a coordinated program of active professional

  • Integrated Services Digital Network (ISDN means a switched network service that provides end-to-end digital connectivity for the simultaneous transmission of voice and data. Basic Rate Interface-ISDN (BRI-ISDN) provides for a digital transmission of two (2) 64 Kbps bearer channels and one (1) 16 Kbps data channel (2B+D).

  • Design Services means architect services, engineer services or landscape architect services.

  • Voice Services means the telecommunications services to be provided to you under Part A and as specified in your Application.

  • Network pharmacy means any pharmacy that has an agreement to accept our pharmacy allowance for prescription drugs and diabetic equipment/supplies covered under this agreement. All other pharmacies are NON-NETWORK PHARMACIES. The one exception and for the purpose of specialty Prescription Drugs, only specialty pharmacies that have an agreement to accept our pharmacy allowance are network pharmacies and all others pharmacies are non-network pharmacies.

  • Online Services means Microsoft-hosted services to which Customer subscribes under this Agreement. It does not include software and services provided under separate license terms.

  • Hosting Services means the provision, administration, and maintenance of servers and related equipment, the provision of bandwidth at the hosting facility, and the operation of the Application for access by Customer Users to be provided by the relevant hosting service provider.

  • Network User means a customer or a potential customer of a transmission system operator, and transmission system operators themselves in so far as it is necessary for them to carry out their functions in relation to transmission;

  • In-network or "participating" means a provider or facility

  • Network Services means the equipment, software, and services necessary to transmit voice, data, or video.

  • Construction Phase Services means the coordination, implementation and execution of the Work required by this Agreement, which are further defined in Article 8.

  • Service(s)(ing) In accordance with Regulation AB, the act of servicing and administering the Mortgage Loans or any other assets of the Trust by an entity that meets the definition of “servicer” set forth in Item 1101 of Regulation AB and is subject to the disclosure requirements set forth in Item 1108 of Regulation AB. For clarification purposes, any uncapitalized occurrence of this term shall have the meaning commonly understood by participants in the commercial mortgage-backed securities market.

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • ACH Network means the funds transfer system, governed by the NACHA Rules, that provides funds transfer services to participating financial institutions.

  • Integrated Services Digital Network (ISDN) means a switched network service that provides end-to-end digital connectivity for the simultaneous transmission of voice and data. Basic Rate Interface-ISDN (BRI-ISDN) provides for a digital transmission of two 64 Kbps bearer channels and one 16 Kbps data channel (2B+D).

  • Network plan means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.

  • Hospice services means palliative and supportive care and other services provided by an interdisciplinary team under the direction of an identifiable hospice administration to terminally ill hospice patients and their families to meet the physical, nutritional, emotional, social, spiritual, and special needs experienced during the final stages of illness, dying, and bereavement, as defined in Minnesota Statutes, § 144A.75, subd. 8, and includes the set of services as determined by the Medicare program under §1861(dd) of the Social Security Act and defined in 42 CFR § 418.3.

  • Customer Services means the call centre for dealing with queries about your Card. You can contact Customer Services by calling 01 693 3333, or contacting us directly.