PPO Provider definition

PPO Provider means a Dental Provider who contracts with the dental plan and agrees to accept the PPO Contracted Fee as payment in full for services provided under the dental plan.
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PPO Provider means an Eligible Provider, Hospital, or other facility that has a written agreement recognized by the Plan to provide health care services to Plan participants at specified costs.
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PPO Provider means a health care service provider that is contracted with and credentialed by a managed care organization to provide quality and cost effective services.
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Examples of PPO Provider in a sentence

  • You might find that a particular PPO Provider may not be accepting new patients.

  • Some Providers choose to be a PPO Provider for only some of our products.

  • Our Preferred Care PPO Network consists of a select group of Physicians, Hospitals and other Allied Health Professionals who have contracted with Us to participate in the Blue Cross and Blue Shield of Louisiana PPO Provider Network and render services to Our Members.

  • If a Provider leaves the Network or is otherwise not available to you, you must choose another PPO Provider to get In-Network benefits.

  • You may see any Dental Provider for your covered treatment whether the Provider is a PPO Provider, Premier Provider or a Non-Delta Dental Provider.

  • This plan is a dental PPO plan and the greatest benefits – including out-of-pocket savings – occur when you choose a PPO Provider.

  • Costs incurred by the Pediatric Enrollee for covered services with a PPO Provider apply towards the Out-of-Pocket Maximum for pediatric dental Benefits.

  • Payment for covered services performed by a PPO Provider is based on the Maximum Contract Allowance.

  • The PPO Provider will accept contracted fees as payment in full for covered services and will not balance bill if there is a difference between Submitted Fees and PPO Contracted Fees.

  • The PPO Provider or Premier Provider will complete the dental Claim Form and submit it to the dental plan for reimbursement.

Related to PPO Provider

  • Hub Provider means an entity that (i) provides Common Channel Signaling (SS7) connectivity between the networks of service providers that are not directly connected to each other; or (ii) provides third party database services such as LIDB. The SS7 messages received by Hub Providers are accepted or rejected by the Hub Provider depending on whether a contractual arrangement exists between the Hub Provider and the message originator (sender) and whether the message originator has contracted for the type of SS7 messages being submitted for transmission to the Hub Provider.

  • New Provider means any replacement service provider or providers engaged to provide the Services (or part thereof) or substantially similar services or the Authority itself where the Services or substantially similar services or part thereof continue to be provided by the Authority after partial termination, termination or expiry of this Contract;

  • Provider is any individual or company that provides professional or technical services.

  • 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.

  • Education service provider means an education management organization, school

  • Third Party Provider means licensors, subcontractors and suppliers of BNYM furnishing the Third Party Products.

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

  • Local Service Provider (LSP) is the LEC that provides retail local Exchange Service to an End User. The LSP may or may not provide any physical network components to support the provision of that End User’s service.

  • 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.

  • Replacement Provider has the meaning set forth in Section II.D.1.

  • Local education provider means a school district

  • Provider agreement means the signed, written, contractual agreement between the department and the provider of services or goods.

  • Ambulance service provider means Latrobe Health Services recognises the following providers for the purposes of paying benefits:

  • financial service provider means a person engaged in the business of providing financial services in terms of authorisation issued or registration granted by a financial sector regulator;

  • Certified service provider means an agent certified:

  • Services Provider means a provider of telecommunications services or other services similar to the Services, including O2 or an O2 Affiliate or any direct or indirect supplier of O2 or an O2 Affiliate;

  • Financial Services Provider means any Lender and any other provider of financial services or products;

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

  • Provider Organization means a group practice, facility, or organization that is:

  • Private provider means any person who contracts with a governmental entity to provide services directly to the public.

  • Data Provider means a Participant that is registered to provide information to GS1 South Africa for use through the Verified by GS1 Services.

  • Payment Initiation Service Provider or “PISP” means an authorised third party provider which provides a service that allows that third party to pass payment instructions to us on your behalf in relation to your Account.

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • Third-party logistics provider means an entity that provides

  • Ambulance provider means an emergency medical service provider that:

  • Local Service Provider (LSP means the LEC that provides retail local Exchange Service to an End User. The LSP may or may not provide any physical network components to support the provision of that End User’s service.