Preferred Provider Network. , “Network” or “PPO” means a network of Providers that contract with a Preferred Provider Organization to provide services to Insureds of the Company at negotiated rates.
Preferred Provider Network means a health care provider or group of providers selected by the Scheme as the preferred provider or providers to provide to the Members of the Scheme diagnosis, treatments and care in respect of one or more conditions at a prenegotiated rate;
Preferred Provider Network means hospitals or Network providers empanelled by ITGI on negotiated package rates to provide cashless facility to you.
Examples of Preferred Provider Network in a sentence
No payment will be made for Organ, Tissue and Bone Marrow Transplant Benefits or evaluations unless the Plan Authorizes these services and the services are rendered by a Blue Distinction Center for Transplants (BDCT) for the specific organ or transplant or a transplant facility in the Blue Cross and Blue Shield of Louisiana Preferred Provider Network, unless otherwise approved by the Plan in writing.
Preferred Provider Network means a network of hospitals which have agreed to a cashless packaged pricing for certain procedures for the insured person.
The Insurer maintains a Preferred Provider Network both within and outside the United States.
A Preferred Provider Network (PPO) shall be offered in Southern California.
In the event specialty services are not available from a Preferred Provider, Preauthorization is required and Out-of-Network Provider services will be covered at the Preferred Provider Network level.
More Definitions of Preferred Provider Network
Preferred Provider Network means an organization responsible for maintaining and providing a network of medical providers to perform medical services for CDCR Patient-Inmates/DJJ Youth.
Preferred Provider Network means a Hospital, clinic or Physician that has entered into an agreement to provide specific medical care at negotiated prices. The Company maintains an international network of medical Providers and facilities with which it has arranged direct billing procedures. Please refer to your Medical Identification Card to locate Preferred Providers, or access a list of Providers at xxx.xxx.xxx. Prescription Drugs are medications which are prescribed by a Physician and which would not be available without such prescription. Certain treatments and medications, such as vitamins, herbs, aspirin, cold remedies, medicines, Experimental and/or Investigational drugs, or medical supplies even when recommended by a Physician, do not qualify as Prescription Drugs. Professional Sports are activities in which the participants receive payment for participation. Provider means the organization or person performing or supplying treatment, services, supplies or drugs.
Preferred Provider Network. A group of Network Providers that MiSalud Enrollees may access without any requirement of a Referral or Prior Authorization; provides services to MiSalud Enrollees without imposing any Co-Payments; and meets the Network requirements described in Article 9 of this Contract.
Preferred Provider Network means a person, which is not a managed care organization, but which pays claims for the delivery of health care services, accepts financial risk for the delivery of health care services and establishes, operates or maintains an arrangement or contract with providers relating to (A) the health care services rendered by the providers, and (B) the amounts to be paid to the providers for such services. “Preferred provider network” does not include (i) a workers’ compensation preferred provider organization established pursuant to section 31‐279‐10 of the regulations of Connecticut state agencies, (ii) an independent practice association or physician hospital organization whose primary function is to contract with insurers and provide services to providers, (iii) a clinical laboratory, licensed pursuant to section 19a‐30, whose primary payments for any contracted or referred services are made to other licensed clinical laboratories or for associated pathology services, or (iv) a pharmacy benefits manager responsible for administering pharmacy claims whose primary function is to administer the pharmacy benefit on behalf of a health benefit plan;
Preferred Provider Network means a person [, which] that is 602 not a managed care organization, but [which] that pays claims for the 603 delivery of health care services, accepts financial risk for the delivery 604 of health care services and establishes, operates or maintains an 605 arrangement or contract with providers relating to (A) the health care 606 services rendered by the providers, and (B) the amounts to be paid to 607 the providers for such services. "Preferred provider network" does not 608 include (i) a workers' compensation preferred provider organization 609 established pursuant to section 31-279-10 of the regulations of
Preferred Provider Network. A group of Network Providers that MI Salud Enrollees may access without any requirement of a Referral or Prior Authorization; provides services to MI Salud Enrollees without imposing any Co-Payments; and meets the Network requirements described in Article 9 of this Contract. Prepaid Inpatient Health Plan (“PIHP”): An entity that: (a) provides medical services to Enrollees under a contract with ASES with prepaid Capitation or other payment arrangements that do not use State plan payment plans; (b) provides, arranges for, or otherwise has responsibility for the provision of any inpatient hospital or institutional services for its Enrollees; and (c) does not have a comprehensive risk contract.
Preferred Provider Network means [an arrangement in