Preferred Provider Agreement definition

Preferred Provider Agreement means an agreement between a Provider and Blue Shield, regardless of the title, enabling such Provider to participate in the Preferred Provider network.
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Preferred Provider Agreement means a contract between or on behalf of a health care insurer and a preferred provider.
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Preferred Provider Agreement means the agreement in the form attached as Annexure 3.
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Examples of Preferred Provider Agreement in a sentence

  • The provisions contained in Part III of these Regulations are applicable to all current and former active versions of the PremierBlue Shield Preferred Provider Agreement, regardless of their title.

  • Blue Shield may reject an application to be a Preferred Provider, or may terminate the participation as a Preferred Provider, in accordance with the terms of the Preferred Provider Agreement, these Regulations and/or Administrative Requirements.

  • The participation of any Provider as a Preferred Provider shall be effective upon acceptance by Blue Shield of Provider’s application, Provider’s satisfaction of all applicable credentialing criteria, and execution of the Preferred Provider Agreement by Blue Shield.

  • A Provider’s participation with Blue Shield as a Preferred Provider shall continue until such time as the Preferred Provider Agreement is terminated by either party in accordance with the terms of the Preferred Provider Agreement.

  • Preferred Provider acknowledges and reaffirms the hold harmless provision in Section 5.11 of Part I of these Regulations and agrees that such provision shall survive the termination of the Preferred Provider Agreement and is to be construed for the benefit of the Members.

  • In the event of the termination of the Preferred Provider Agreement by Blue Shield or Preferred Provider, Preferred Provider agrees upon request to cooperate with Blue Shield in Blue Shield obtaining information from Preferred Provider regarding those Members enrolled in a Managed Care Plan that may be affected by such termination because they are undergoing an ongoing course of treatment or are otherwise active patients of Preferred Provider.

  • The explanation of benefits shall include at a minimum, a listing of billed charges, the charges as adjusted under a Preferred Provider Agreement, charges not eligible, charges paid, deductible applied, calculation of rate paid, listing of payees and amounts, the amount to be paid by the Participant including the amount of any balance billing liability, and the reason for ineligibility or denial if applicable.

  • The provisions in Sections 2.3 of the Participating Provider Agreement, the Preferred Provider Agreement, and/or the Government Sponsored Programs Provider Agreement as applicable; Sections 4.3, 4.4, 4.5, 5, 6, 9, and 12 of Part I of these Regulations; and Section 2 of Part II of these Regulations; and Section 6 of Part III of these Regulations; and Section 2 of Part IV of these Regulations shall survive the termination of this Agreement, regardless of the cause giving rise to such termination.

  • Preferred Provider will, at its expense, make all books, records, documents and other evidence relating to adultBasic and/or CHIP, as the case may be, and the services rendered by Preferred Provider to adultBasic/CHIP Members under the Preferred Provider Agreement and these Regulations, available for audit, review or evaluation by Blue Shield, applicable Official Bodies of the Commonwealth of Pennsylvania, or any of the preceding entities’ designated representatives.

  • In April 2013, after GeoMet and USURF terminated the Preferred Service Provider Agreement, GeoMet and AWSF entered into a Preferred Provider Agreement.


More Definitions of Preferred Provider Agreement

Preferred Provider Agreement is defined in Section 2.3(a)(vii).
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Preferred Provider Agreement means that agreement dated the date hereof between Sellers and Buyer substantially in the form attached hereto as Exhibit B.
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Preferred Provider Agreement means an agreement between a Provider and the Network pursuant to which negotiated rates are established for payment of covered services rendered to a Participant.
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Preferred Provider Agreement means the agreement between MedAire and PT Medika Jasa Utama as set out in Annexure 3.
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Preferred Provider Agreement. ’ shall mean an agreement between a Provider and Blue Shield, regardless of the title, enabling such Provider to participate in the Preferred Provider network.
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Related to Preferred Provider Agreement

  • Preferred Provider Organization (PPO) means a health insurance issuer's or carrier's insurance policy that offers covered health care services provided by a network of providers who are contracted with the issuer or carrier (“in-network”) and providers who are not part of the provider network (“out-of-network”).

  • Preferred Provider or “Network Provider” means a doctor, hospital, medical facility or other provider of health care which is included in a network which has been designated by the Fund to render health related services to Fund participants.

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

  • Medicaid Provider Agreement means an agreement entered into between a state agency or other such entity administering the Medicaid program and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicaid patients in accordance with the terms of the agreement and Medicaid Regulations.

  • Provider Agreements means all participation, provider and reimbursement agreements or arrangements now or hereafter in effect for the benefit of Tenant or any Manager in connection with the operation of any Facility relating to any right of payment or other claim arising out of or in connection with Tenant’s participation in any Third Party Payor Program.

  • Hospital purchaser/provider agreement (HPPA agreement) means a negotiated agreement entered between the fund and the hospital for the cost of hospital treatment.

  • Medicare Provider Agreement means an agreement entered into between CMS or other such entity administering the Medicare program on behalf of CMS, and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Related provider trust means a titling trust or other trust established by a licensed viatical settlement provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. The trust shall have a written agreement with the licensed viatical settlement provider under which the licensed viatical settlement provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files related to viatical settlement transactions available to the commissioner as if those records and files were maintained directly by the licensed viatical settlement provider.

  • Bank Product Provider Agreement means an agreement in substantially the form attached hereto as Exhibit B-2 to this Agreement, in form and substance satisfactory to Agent, duly executed by the applicable Bank Product Provider, the applicable Loan Parties, and Agent.

  • Master Services Agreement means that master services agreement among the Limited Partnership, the Company, Teekay Corporation and Brookfield XX XXXX L.P. dated as of the date hereof.

  • TRIPS Agreement means the Agreement on Trade-Related Aspects of Intellectual Property Rights in Annex 1C to the WTO Agreement;

  • Applied Provider Advance has the meaning assigned to such term in Section 2.06(a).

  • Qualified provider means a person or business experienced in the design, implementation, and installation of energy conservation measures. A qualified provider to whom the contract is awarded shall give a sufficient bond to the municipality for its faithful performance.

  • Registered Provider means a registered provider of social housing (see section 80 of the Housing and Regeneration Act 2008);

  • Shared Services Agreement means an agreement entered into between two or more municipalities, including the District Municipality, whereby the participating municipalities agree to share services described in the agreement;

  • Unapplied Provider Advance means any Provider Advance other than an Applied Provider Advance.

  • 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 contract means any contract between a provider and a carrier (or a carrier's network,

  • Derivative Provider Trigger Event means (i) an Event of Default with respect to which Party A is a Defaulting Party, (ii) a Termination Event with respect to which Party A is the sole Affected Party or (iii) an Additional Termination Event with respect to which Party A is the sole Affected Party.

  • Services Agreement means an agreement entered into between a Utility and one or more Affiliates for the provision of Shared Services or For Profit Affiliate Services and shall provide for the following matters as appropriate in the circumstances:

  • Transitional Services Agreement shall have the meaning ascribed in Section 6.12.

  • SPS Agreement means the Agreement on the Application of Sanitary and Phytosanitary Measures which is a part of the WTO Agreement; Subheading means the first six digits in the tariff classification number under the HS; Territory means:

  • Maintenance agreement means a document recorded in the land records that acts as a property deed restriction, and which provides for long-term maintenance of stormwater management practices.

  • Enhancement Agreement means any agreement, instrument or document governing the terms of any Series Enhancement or pursuant to which any Series Enhancement is issued or outstanding.

  • Cardholder Agreement means the agreement between Bank and a Cardholder governing the terms and use of a Card.

  • Claims Allocation and Handling Agreement means the agreement of that name approved by XXX;