Plan Providers definition

Plan Providers means the physicians, hospitals, skilled nursing facilities, home health agencies, pharmacies, medical transportation companies, laboratories, radiology and diagnostic facilities, durable medical equipment suppliers and other licensed health care entities or professionals who are part of the selected Plan Network and who provide Benefits to Members through an agreement with Plan. Plan Providers are listed in the Provider Directory. For purposes of Mental Health or Substance Use Disorders, Plan Providers also include : (a) A person who is licensed under Division 2 (commencing with Section 500) of the Business and Professions Code. (b) An associate marriage and family therapist or marriage and family therapist trainee. (c) A qualified autism spectrum disorder service provider or qualified autism spectrum disorder service professional certified by a national entity. (d) An associate clinical social worker. (e) An associate professional clinical counselor or professional clinical counselor trainee. (f) A registered psychologist. (g) A registered psychological assistant. (h) A psychology trainee.
Sample 1Sample 2Sample 3
Plan Providers means the physicians, hospitals, skilled nursing facilities, home health agencies, pharmacies, medical transportation companies, laboratories, X-ray facilities, durable medical equipment suppliers and other licensed health care entities or professionals who are part of the selected Plan Network and who provide Benefits to Members through an agreement with Plan.
Sample 1
Plan Providers means the physicians, hospitals, skilled nursing facilities, home health agencies, pharmacies, medical transportation companies, laboratories, radiology and diagnostic facilities, durable medical equipment suppliers and other licensed health care entities or professionals who are part of the selected Plan Network and who provide Benefits to Members through an agreement with Plan. Plan Providers also include Qualified Autism Service Providers, Qualified Autism Service Professionals, and Qualified Autism Service Paraprofessionals who are part of the Member’s Plan Network and who provide Covered Benefits to Members through an agreement with Plan. Plan Providers are listed in the Provider Directory.
Sample 1

Examples of Plan Providers in a sentence

  • Covered Services from Plan Providers are paid at the In-Plan level and are covered in full, except for any Deductibles, Copays and Reductions of Benefit listed in this EOC.

  • Plan Providers are free to join and leave our network at any time.

  • For purposes of this provision, the public does not include Plan Providers' representatives who are actively engaged in promoting the Funds.

  • Emergency Services obtained from Non-Plan providers will be payable at the same benefit level as would be applied to care received from Plan Providers.

  • If you still refuse to accept the recommended Services, the Health Plan and Plan Providers have no further responsibility to provide or cover any alternative treatment you may request for that condition.

  • This Agreement and Exhibit A may be amended at any time by Distributor without Plan Provider's consent by Distributor mailing a copy of an amendment to Plan Provider at the address set forth below.

  • Summary Chart In-Plan Level of Benefits (Care from In-Plan Providers)When you use Plan Providers, you will not have to submit claim forms.

  • Plan Providers are paid in various ways, including salary, capitation, per diem rates, case rates, fee for service and incentive payments.

  • Plan Providers are not agents or employees of HPN; nor is HPN, or any employee of HPN, an employee or agent of a Plan Provider.

  • The relationship between HPN and Plan Providers is an independent contractor relationship.


More Definitions of Plan Providers

Plan Providers has the meaning set forth in Recital C.
Sample 1

Related to Plan Providers

  • Plan Provider means a Provider which has a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered to you.

  • Non-Plan Provider means a Provider that does not meet the definition of Plan Provider unless otherwise specified in the definition of a particular Provider.

  • Data Providers means pricing vendors, analytics providers, brokers, dealers, investment managers, Authorized Persons, Subcustodians, Depositories and any other Person providing Market Data to the Custodian.

  • Service Providers has the meaning set out in Section 9(e).

  • Participating Provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • Training provider means an organization meeting the eligibility conditions as mentioned in Data Sheet and selected in accordance with the criteria set forth for the purpose.

  • Providers means individuals or organizations --------- licensed to practice dentistry (including specialists) as well as other dental professionals who provide ancillary reimbursable dental services.

  • Third Party Service Providers means any third party wherever situated selected by us or any member of the BEA Group to provide services to it.

  • The Service Provider means the Bidder or firm supplying the Services under this Contract.

  • Service Provider Personnel means and refers to Service Provider employees or subcontractors hired and maintained to perform Services hereunder.

  • Enhanced Service Provider (ESP) is a provider of enhanced services as those services are defined in 47 CFR Section 64.702.

  • Housing Provider means, with respect to a HOME Development, Local Government, consortia approved by HUD under 24 CFR Part 92, for-profit and Non-Profit Developers, and qualified CHDOs, with demonstrated capacity to construct or rehabilitate affordable housing.

  • Nonparticipating provider means a person, health care provider, practitioner, facility, or entity, acting within their scope of practice, that does not have a written contract to participate in a managed health care system's provider network, but provides health care services to enrollees of programs authorized under this chapter or other applicable law whose health care services are provided by the managed health care system.

  • Common Service Provider means a person nominated by the ICSDs to perform the role of common service provider;

  • Non-Participating Provider means an Administrator Hospital or Professional Provider which does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or a facility which has not been designated by the Claim Administrator as a Participating Provider.

  • Third Party Providers or “TPPs” means any payment service provider that provides payment services to you or someone else that concerns the Account, for example, an AISP (described in Clause 1(c) below).

  • Professional Provider means a Physician, Dentist, Podiatrist, Psychologist, Chiropractor, Optometrist or any Provider designated by the Claim Administrator or another Blue Cross and/or Blue Shield Plan.

  • Individual provider means an individual provider as defined

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

  • Medical provider means a medical service provider, a hospital, a medical clinic, or a vendor of medical services.

  • Education service provider means an education management organization, school

  • Information Service Provider A provider of Information Service. Information Service Provider includes, but is not limited to, Internet Service Providers (ISPs).

  • Risk Retention Consultation Party means each risk retention consultation party appointed pursuant to the Lead Securitization Servicing Agreement.

  • Account Information Service Provider means a payment service provider pursuing business activities as referred to in point (8) of Annex I;

  • Enhanced Service Provider (ESP) means the provider of enhanced services, as those services are defined in 47 CFR Section 64.702.

  • Principals or Key Personnel means and refers to those principals and key personnel of the Contractor, and its or their agents, as described in C.G.S. §§ 4-250(5) and 4-252(c)(1)(B) and (C).