Provider Handbook definition

Provider Handbook means a publication developed by the department for the use of providers which outlines program policies and includes instructions on claim filing and other aspects of participation in MA.
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Provider Handbook or “Provider Manual” means a document that provides information to a Medicaid provider regarding recipient eligibility, claims submission and processing, provider participation, covered care, goods, or services and limitations, procedure codes and fees, and other matters related to Medicaid program participation.
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Provider Handbook means HSD’s manual for providers of services that contains standard forms, performance measures, and other documents and standard practices, as same may be amended from time to time by County, which Handbook is incorporated in this Agreement by reference.
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Examples of Provider Handbook in a sentence

  • Policy on the Pharmacy Services Lock-In Program can be found in the BadgerCare Plus and Medicaid Pharmacy Provider Handbook.

  • Providers must also adhere to standards and requirements set forth in the Broward County, Human Services Department, Community Partnerships Division Provider Handbook for Contracted Services Providers, individual contracts, and applicable contract adjustments.

  • All Providers shall be required to adhere to the terms and conditions of the Credentialed Service Provider Handbook promulgated by the Department and the Department's Credentialed Administrative Services Organization.

  • The Handbook contains our policies, instructions, and guidelines to enable providers to : >Know which services are provided and covered for eligible beneficiaries >Submit proper billings for services rendered >Make inquiries to the proper source when it is necessary to obtain clarification Magellan Complete Care offers a Provider Handbook via the website available to view or download.

  • The Contractor may choose not to distribute the Provider Handbook via mail, provided it submits a written notification to all Providers that explains how to obtain the Provider Handbook from the CMO’s Web site.

  • The 2017 Provider Handbook of Magellan Complete Care of Florida can be viewed or printed from our website within the provider tab.

  • The Purchase of Service Provider Handbook shall be given to the provider at the beginning of the process of developing a contract.c. Contract proposal development.

  • Community Partnerships Division (CPD) Provider Handbook (Handbook) details CPD’s policies, procedures, requirements, and standards for compliance with a Broward County (County) Human Services agreement.

  • CLEAN CLAIM - A claim that complies with the State requirements and Provider Handbook, if it is a paper claim, or the requirements of the HIPAA, if it is an electronic claim, that is received timely by Managed Care Plan or its delegee and has no defect, impropriety or lack of substantiating documentation from the Enrollee's medical or Provider records for Covered Services.

  • The Care Manager will authorize and coordinate the provision of Covered Services rendered under this Agreement and as may be referenced in the Provider Handbook.


More Definitions of Provider Handbook

Provider Handbook means the ODS dental provider handbook applicable to the government program under which Member is enrolled and as amended by ODS and available at the website listed on the applicable attached exhibit(s).
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Provider Handbook means the proprietary VBH document which contains VBH’ Provider policies and procedures and which VBH, in its sole discretion, may amend from time to time.
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Provider Handbook means the rules, policies, and procedures of HMO regarding, among other matters, utilization review, quality assurance, 6 grievance procedures, pre-authorization and referral requirements and credentialing and recredentialing standards and policies. HMO shall give IPA 30-calendar day's prior written notice of any revisions or modifications to the Provider Handbook, which materially change the obligations of the parties or an IPA Provider. If IPA does not provide notice objecting within the 30 days, the modifications shall be deemed approved, unless such revisions or modifications are required for compliance with law in which case they shall become effective immediately.
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Provider Handbook. A Program-specific set of comprehensive written guidelines, instructions, rules, policies and procedures as established and published by TriWest for participating Providers, as may be amended from time to time by TriWest in accordance with the provisions of this Agreement.
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Related to Provider Handbook

  • Provider Manual means a working document, including but not limited to BCBSM published bulletins and provider notices, that provide specific guidelines and direction by which providers may meet their contractual responsibility as described in this Agreement. Provider Manuals are published on web-DENIS.

  • PRA Handbook means the PRA Handbook of Rules and Guidance as amended from time to time.

  • COGE Handbook means the Canadian Oil and Gas Evaluation Handbook prepared jointly by The Society of Petroleum Evaluation Engineers (Calgary Chapter) and the Canadian Institute of Mining, Metallurgy & Petroleum (Petroleum Society), as amended from time to time.

  • FCA Handbook means the FCA Handbook of Rules and Guidance as amended from time to time.

  • the Handbook means the Authority’s Handbook of rules and guidance;

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

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

  • Handbook means the Handbook of the Canadian Institute of Chartered Accountants, as amended from time to time;

  • 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.

  • Procedures Manual means the standards and procedures manual described in Section 11.3.

  • Provider Personnel means all persons employed or engaged by the Provider together with the Provider’s servants, agents, consultants and Sub-Contractors (and all persons employed by any Sub-Contractor together with the Sub-Contractor’s servants, consultants, agents, Provider’s and Sub-Contractors) used in the performance of its obligations under this Agreement;

  • 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.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Policies and Procedures means the written policies and procedures of the Client in any way related to the Services, including any such policies and procedures contained in the Organic Documents and the Offering Documents.

  • Operations Manual means a manual containing procedures, instructions and guidance for use by operational personnel in the execution of their duties;

  • 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.

  • Academies Financial Handbook means the document with that title published by the EFA and amended from time to time, on behalf of the Secretary of State.

  • 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.

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • DOD means the United States department of defense.

  • Employee Handbook means the employee handbook applicable to all employees of Infosys during the entire tenure of their employment.

  • Customer Proprietary Network Information (“CPNI”) is as defined in the Act.

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

  • Provider panel means those providers with which a carrier contracts to provide health care services

  • Project Manual means the volume usually assembled for the Work which may include the bidding requirements, sample forms, and other Contract Documents.