Provider Operations Manual definition

Provider Operations Manual refers to the manual approved by the Department and posted on the LME/PIHP website.
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Provider Operations Manual. (also Provider Manual) refers to the manual developed by LME/PIHP pursuant to its contracts with the Department and posted on the LME/PIHP website for use and reference by Contractor.
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Provider Operations Manual refers to the manual approved by the Department and posted on the LME/PIHP website. “State-funded consumer” refers to an individual who receives Mental Health, Developmental Disability, and/or Substance Abuse (MH/DD/SA) services that are paid with State funds (which may include state and/or federal block grant funds). “Unmanaged Visits” refers to visits not requiring prior authorization. BASIC RELATIONSHIP: CONTRACTOR enters into this contract with LME/PIHP for the purpose of providing medically necessary MH/DD/SA services to the LME/PIHP’s Enrollee(s) and agrees to comply with Controlling Authority, the conditions set forth in this Contract and all Appendices or Attachments to this Contract. CONTRACTOR is an independent contractor of LME/PIHP. This Contract is not intended and shall not be construed to create the relationship of agent, servant, employee, partnership, joint venture, or association between the parties, their employees, partners, or agents but rather CONTRACTOR is an independent contractor of the LME/PIHP. Further, neither party shall be considered an employee or agent of the other for any purpose including but not limited to, compensation for services, employee welfare and pension benefits, workers’ compensation insurance, or any other fringe benefits of employment.
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Examples of Provider Operations Manual in a sentence

  • Amendments to the Quick Reference Guide and the Louisiana Child Care Provider Operations Manual will be provided hard copy.

  • Section L of the Provider Operations Manual sets forth Alliance’s Retention Criteria (the “Retention Criteria”).

  • Pursuant to federal law and the State contracts Alliance has developed provider selection and retention policies, which are included in the Alliance Provider Operations Manual.

  • In conformity with federal law and the State contracts, Alliance has developed provider selection and retention policies, which are included in the Alliance Provider Operations Manual.

  • At the time of installation, the Provider or authorized person will be trained and provided one (1) Quick Reference Guide and one (1) Louisiana Child Care Provider Operations Manual.

  • Comply with the terms applicable to providers set forth in 1) the Request for Services issued by the State of Indiana in connection with the Medicaid program, 2) the managed care organization ("MCO") contract, including incorporated documents, between Anthem and the State of Indiana, which applicable terms are incorporated herein by reference and 3) the Provider Operations Manual.

  • For appeal information, please refer to the LME/PIHP Provider Operations Manual.

  • Comply with the terms applicable to Facility set forth in 1) the Request for Services issued by the State of Indiana in connection with the Healthy Indiana Plan, 2) the managed care organization ("MCO") contract, including incorporated documents, between Anthem and the State of Indiana, which applicable terms are incorporated herein by reference and 3) the Provider Operations Manual.

  • Comply with the terms applicable to Provider set forth in 1) the Request for Services issued by the State of Indiana in connection with the Healthy Indiana Plan, 2) the managed care organization ("MCO") contract, including incorporated documents, between Anthem and the State of Indiana, which applicable terms are incorporated herein by reference and 3) the Provider Operations Manual.

  • Purpose of the Provider Operations ManualThe Provider Operations Manual describes Alignment’s policies and operating procedures.


More Definitions of Provider Operations Manual

Provider Operations Manual means the manual that is posted on the Partners BHM website, which has specific guidelines, instructions and requirements relating to this contract.
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Provider Operations Manual or “Provider Manual” means the provider manual and any billing manuals adopted by the BH I/DD Tailored Plan and may include, without limitation, requirements relating to billing, credentialing, utilization management, quality management, grievances and appeals, on-site reviews and State requirements, and may be unilaterally amended from time to time by the BH I/DD Tailored Plan.
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Provider Operations Manual means the Anthem Medi-Cal Provider Operations Manual. The Provider Operations Manual is incorporated herein by this reference and applies to all Anthem Medi-Cal Managed Care Plans.
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Provider Operations Manual means the compilation of policies, procedures, standards and specific documents pertaining to the Benefit Plan that has been compiled by Governing Board for the use and instruction of Provider, and to which Provider must adhere. The Provider Operations Manual may be unilaterally amended or modified from time to time by Governing Board.
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Related to Provider Operations Manual

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

  • Project Operations Manual or “POM” means the Recipient’s manual referred to in Section I.D of Schedule 2 to this Agreement, as such manual may be amended from time to time with the agreement of the Association.

  • 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.

  • Program Manual means the United States Department of Agriculture, Animal and Plant Health Inspection Service, Plant Protection and Quarantine, Gypsy Moth Program Manual, 1994 edition.

  • PJM Manuals means the instructions, rules, procedures and guidelines established by the Office of the Interconnection for the operation, planning, and accounting requirements of the PJM Region and the PJM Interchange Energy Market. PJM Region:

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

  • 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;

  • Supplier Operations means all assets, processes and systems (including information systems), data (including Customer data), personnel, and sites, used or processed by Supplier from time to time in the performance of this Agreement.

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

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

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

  • Operating Manual means the document that contains the procedures and forms for the operation of bungee jumping equipment and activity at a site.

  • 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.

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • Operations Manager means each of the Company and Provider payroll, benefits and information technology representatives on the Operations Management Team as identified in Section 6.0 below.

  • Customer Services means the call centre for dealing with queries about your Card. You can contact Customer Services by calling 01 693 3333, or contacting us directly.

  • Design Manual means the MOHLTC design manual or manuals in effect and applicable to the development, upgrade, retrofit, renovation or redevelopment of the Home or Beds subject to this Agreement.

  • Program services means services that include all of the following provided they are pursuant to a program agreement: program needs assessment and development, job task analysis, curriculum development and revision, instruction, instructional materials and supplies, computer software and upgrades, instructional support, administrative and student services, related school to career training programs, skill or career interest assessment services and testing and contracted services.

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

  • Provider Service means a Provider’s hosted online services (if any) as described in the Solution Exhibit which is provided by Provider to Customers located in the Territory through remote access via the Internet as part of the BPO Service. A Provider Platform Application shall be considered a Provider Service.

  • system user means a natural or legal person supplying to, or being supplied by, a transmission or distribution system;

  • Managed care plan means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with or employed by the health carrier.

  • Procurement Manual means the Procurement Manual set forth as chapter 4 of the PIP (as hereinafter defined), which Manual sets forth the procurement management and institutional arrangements and obligations under the Project as such Manual may be amended from time to time by agreement between the Association and Recipient.

  • Service Locations means those locations set forth on Exhibit B.

  • Passenger Services means the Franchisee's railway passenger services as specified in any Timetable and/or Plan of the Day including those railway passenger services which the Franchisee may delegate or subcontract or otherwise secure through any other person from time to time in accordance with the Franchise Agreement;

  • Fiserv means Fiserv, Inc., a Wisconsin corporation.