Plan Medical Group definition

Plan Medical Group or "PMG" means a group of physicians, organized as or contracted through a legal entity, that has met Plan's criteria for participation and has entered into an agreement with Plan to provide and make available Professional Services, and to provide or coordinate the provision of other Benefits to Members and that is included in the selected Plan Network.
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Examples of Plan Medical Group in a sentence

  • You will not be required to obtain Prior Authorization for sexual and reproductive health services within your Plan Medical Group.

  • In the event an oral or written complaint, grievance or appeal is presented to Medical Group or any of its Participating Providers relating to benefits or coverage under a Managed Care Plan, Medical Group or its Participating Providers will immediately refer Members to contact PacifiCare or deliver any written complaint, grievance or appeal to PacifiCare for handling pursuant to the Member Appeals and Grievance Procedures.

  • If during the term of this Agreement a government agency or other taxing authority imposes or increases a tax or other charge (other than a tax on or measured by net income) upon Health Plan, Medical Group, or Kaiser Foundation Hospitals or upon any activity of any of them, then upon 31 days prior written notice, Health Plan may increase Group’s Premium to include Group’s share of the new or increased tax or charge.

  • Until such Members are transferred, following the termination date of the applicable Managed Care Plan, Medical Group shall be obligated to continue to provide services pursuant to Section 8.3 (the continuing care provisions) of this Agreement.

  • Each Enrolled Employee shall select a Plan Medical Group (“PMG”) and a Primary Care Physician from the selected Plan Network on behalf of himself or herself and each of his or her Dependents at the time of enrollment in Plan.

  • Xxxxxx Permanente is comprised of three entities: the Health Plan, Medical Group and Plan Hospitals.

  • Each Plan Medical Group is affiliated with at least one Plan Hospital.

  • Unless otherwise indicated in writing to Health Plan, Medical Group warrants and authorizes Xxxxxxx Medical Management Corporation to act as its fully authorized representative to represent Medical Group in this Agreement and to receive any and all communications and notices hereunder.

  • The Enrolled Employee may select a different Plan Medical Group and/or Primary Care Physician from the selected Plan Network for himself or herself and for each of his or her Dependents.

  • Health Plan, Medical Group and its Participating Providers shall not request, demand, require or seek directly or indirectly the transfer, discharge or removal of any Member for reasons of Member's need for, or utilization of, Covered Services, except in accordance with the procedures established by Health Plan for such action.

Related to Plan Medical Group

  • Qualified medical provider means the same as that term is defined in Section 26-61a-102.

  • Pharmacy benefits management means the administration or management of prescription drug

  • Insurance holding company system means a group of two or more affiliated persons, at least one of whom is an insurer.

  • Medical Foods means any nutritional substances in any form that are:

  • Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.

  • School-sponsored media means all student media that are:

  • Medical care means amounts paid for:

  • Odyssey means Odyssey Trust Company.

  • Gap medical benefits means the benefits (if any) payable in respect of medical expenses that are less than, greater than or equal to the schedule fee, provided always that the medical expenses relate to a professional service that:

  • Medical Executive Committee or “MEC” means the Executive Committee of the Medical Staff.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Psychiatric hospital means an Institution constituted, licensed, and operated as set forth in the laws that apply to Hospitals, which meets all of the following requirements:

  • Health care corporation means a health care corporation incorporated under the nonprofit health care corporation reform act, 1980 PA 350, MCL 550.1101 to 550.1704.

  • Medical home means a team approach to providing health care that originates in a primary care setting; fosters a partnership among the patient, the personal provider, and other health care professionals, and where appropriate, the patient’s family; utilizes the partnership to access and integrate all medical and nonmedical health-related services across all elements of the health care system and the patient’s community as needed by the patient and the patient’s family to achieve maximum health potential; maintains a centralized, comprehensive record of all health-related services to promote continuity of care; and has all of the characteristics specified in section 135.158.

  • ITT has the meaning given to it in the recitals to this Framework Agreement;

  • Non-Administrator Hospital means a Hospital that does not meet the definition of an Administrator Hospital.

  • Care Plan means a licensee's written description of a resident's needs, preferences, and capabilities, including by whom, when, and how often care and services are to be provided.

  • Critical group means the group of individuals reasonably expected to receive the greatest exposure to residual radioactivity for any applicable set of circumstances.

  • Medical history means information regarding any:

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

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Executive Management means the CEO and the CFO for purposes of administering this Plan.

  • Emergency medical care means such medical procedures as:

  • Risk retention group means any corporation or other limited liability association:

  • Asset Management Plan means a strategic document that states how a group of assets are to be managed over a period of time. The plan describes the characteristics and condition of infrastructure assets, the levels of service expected from them, planned actions to ensure the assets are providing the expected level of service, and financing strategies to implement the planned actions. The plan may use any appropriate format, as long as it includes the information and analysis required to be in a plan as described in Ontario’s Building Together: Guide for Asset Management Plans.

  • School health services means health services provided by a qualified school nurse or other qualified person that are designed to enable a child with a disability to receive FAPE as described in the child’s IEP.