Payer Plan definition

Payer Plan means a program agreed upon pursuant to a Payer Agreement by IPA and a Payer that includes a panel of Participating Providers selected by IPA and/or Payer to provide Covered Services.
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Payer Plan. Agreements shall mean those certain agreements between (i) TMHC and/or Provider, and (ii) Payers that describe the terms and conditions for the provision of Covered Services to Covered Persons by TMHC and/or Provider in accordance with each Payer's Payer Plan.
Sample 1

Examples of Payer Plan in a sentence

  • Consistent with such policies and agreements, IPA shall notify Physician at least thirty (30) days in advance of the effective date of any Payer Agreement providing a Payer Plan in which Physician may wish to participate pursuant to Section 4.1 of this Agreement.

  • Physician agrees to comply with all operational and procedural rules and regulations promulgated by those Payers whose Payer Plan Physician has accepted under this Agreement.

  • Consistent with sound medical practice and in accordance with accepted community professional standards for rendering quality medical care, Physician agrees to use his or her best effort to make referrals of Covered Persons to the Participating Physicians and other Participating Providers in the relevant Payer Plan.

  • For any Payer Plan, the IPA will furnish Physician with the reimbursement schedule and/or any other pertinent information applicable to such Payer Plan.

  • Physician shall have seven (7) days from receipt of such information to notify IPA in writing of his or her decision not to participate in this Payer Plan.

  • IPA cannot warrant or guarantee (1) that Physician will participate in a minimum number of provider panels or Payer Plans, or (2) that, as a Participating Provider, Physician will be utilized by a minimum number of Covered Persons within any Payer Plan, or (3) that Physician will indefinitely remain a member of the provider panel or Payer Plan.

  • Unless IPA receives timely written notice from Physician accepting such Payer Plan, Physician shall be deemed to have rejected such Payer Plan.

  • Rejection of a Payer Plan shall not terminate Physician’s obligations under this Agreement with respect to Covered Services to be provided to Covered Persons of other Payers under Payer Agreements previously or subsequently accepted by Physician.

  • Provider agrees to notify Members, in advance of providing any uncovered services that the service is not covered by the Payer Plan and that Member will be responsible for all charges.

  • Except for Emergency Care, Provider shall verify with the applicable Payer Plan the eligibility of a Member before admitting or providing Covered Services to such Member.

Related to Payer Plan

  • Multi-employer Plan means a multi-employer plan, as defined in Section 4001(a)(3) of ERISA to which the Borrower or any Subsidiary of the Borrower or any ERISA Affiliate is making or accruing an obligation to make contributions or has within any of the preceding five plan years made or accrued an obligation to make contributions.

  • Multiemployer Plans means “multiemployer plans” as defined by Section 3(37) of ERISA.

  • Multiemployer Pension Plan means a multiemployer plan, as defined in Section 4001(a)(3) of ERISA, to which Borrower or any member of the Controlled Group may have any liability.

  • Pension Plans The meaning specified in Section 4.1(v).

  • Multiemployer Plan means a multiemployer plan as defined in Section 4001(a)(3) of ERISA.

  • Buyer Plans has the meaning set forth in Section 6.02(b).

  • Pension Plan means any “employee pension benefit plan” (as such term is defined in Section 3(2) of ERISA), other than a Multiemployer Plan, that is subject to Title IV of ERISA and is sponsored or maintained by the Borrower or any ERISA Affiliate or to which the Borrower or any ERISA Affiliate contributes or has an obligation to contribute, or in the case of a multiple employer or other plan described in Section 4064(a) of ERISA, has made contributions at any time during the immediately preceding five plan years.

  • Single Employer Plan any Plan which is covered by Title IV of ERISA, but which is not a Multiemployer Plan.

  • Foreign Plans shall have the meaning set forth in Section 3.11(d).

  • Foreign Plan means any employee benefit plan, program, policy, arrangement or agreement maintained or contributed to by the Borrower or any of its Subsidiaries with respect to employees employed outside the United States.

  • ERISA Plan means an employee benefit plan maintained for employees of any Person or any ERISA Affiliate of such Person subject to Title IV of ERISA (other than a Multiemployer Plan).

  • ERISA Plans shall have the meaning set forth in Section 3.13(a).

  • Title IV Plans means all Pension Plans that are subject to Title IV of ERISA, 29 U.S.C. Section 1301 et seq., other than Multi-Employer Plans.

  • Title IV Plan means a pension plan subject to Title IV of ERISA, other than a Multiemployer Plan, to which any ERISA Affiliate incurs or otherwise has any obligation or liability, contingent or otherwise.

  • Foreign Pension Plan means any plan, fund (including, without limitation, any superannuation fund) or other similar program established or maintained outside the United States of America by the Borrower or any one or more of its Subsidiaries primarily for the benefit of employees of the Borrower or such Subsidiaries residing outside the United States of America, which plan, fund or other similar program provides, or results in, retirement income, a deferral of income in contemplation of retirement or payments to be made upon termination of employment, and which plan is not subject to ERISA or the Code.

  • Canadian Pension Plans means each pension plan required to be registered under Canadian federal or provincial law that is maintained or contributed to by a Credit Party for its employees or former employees, but does not include the Canada Pension Plan or the Quebec Pension Plan as maintained by the Government of Canada or the Province of Quebec, respectively.

  • Employee Plan means an employee benefit plan within the meaning of Section 3(3) of ERISA (other than a Multiemployer Plan), regardless of whether subject to ERISA, that any Loan Party or any of its ERISA Affiliates maintains, sponsors or contributes to or is obligated to contribute to.

  • Multiple Employer Plan means a Plan which has two or more contributing sponsors (including the Borrower or any ERISA Affiliate) at least two of whom are not under common control, as such a plan is described in Section 4064 of ERISA.

  • Title IV-E means title IV-E of the Social Security Act [Pub. L. 96-272, title I, sec. 101(a)(1); 94 Stat. 501; 42 U.S.C. 670 et seq.], as amended.

  • Benefit Arrangement means at any time an employee benefit plan within the meaning of Section 3(3) of ERISA which is not a Plan or a Multiemployer Plan and which is maintained or otherwise contributed to by any member of the ERISA Group.

  • Title IV-A means part A of subchapter IV of the social security

  • ERISA Affiliate Plan means each Employee Benefit Plan sponsored or maintained or required to be sponsored or maintained at any time by any ERISA Affiliate, or to which such ERISA Affiliate makes or has made, or has or has had an obligation to make, contributions at any time, or with respect to which such ERISA Affiliate has any liability or obligation.

  • Parent ERISA Affiliate means any corporation or trade or business (whether or not incorporated) which is (or at any relevant time was) treated with Parent or any of its Subsidiaries as a single employer within the meaning of Section 414 of the Code.

  • Canadian Pension Plan means a pension plan or plan that is subject to applicable pension benefits legislation in any jurisdiction of Canada and that is organized and administered to provide pensions, pension benefits or retirement benefits for employees and former employees of any Loan Party or any Subsidiary thereof.

  • Foreign Benefit Arrangement means any employee benefit arrangement mandated by non-U.S. law that is maintained or contributed to by any Credit Party or any of its Subsidiaries.

  • Company ERISA Affiliate means all employers (whether or not incorporated) that would be treated together with the Company or any of its Subsidiaries as a “single employer” within the meaning of Section 414 of the Code.