Provider or Physician Group definition

Provider or Physician Group physician group" means a partnership, limited partnership, limited liability company, corporation or professional corporation, composed of doctors of medicine and/or doctors of osteopathy and/or advanced practice registered nurses, and/or physician assistants who provide health care of the nature provided by independent practitioners and are permitted by state and federal law and regulations to receive SoonerCare provider payments.
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Provider or Physician Group means a partnership, limited partnership, limited liability company, corporation or professional corporation composed of doctors of medicine and/or doctors of osteopathy and/or advanced UregisteredU nurse practitioner UpractitionersU, and/or physician assistants who provide health care of the nature provided by independent practitioners and is UareU permitted by state and federal law and regulations to receive Medicaid USoonerCareU provider payments.U“SoonerCare” means the Medicaid program administered by the Oklahoma Health Care Authority.U “SoonerCare Choice” means a comprehensive medical benefit plan featuring a medical home including a Primary Care Provider for each member.U317:25-7-5. Primary care provider/case managers UprovidersFor provision of health care services, the OHCA contracts with qualified Primary Care Provider/Case Managers UProvidersU. All providers serving as PCP/CMs UPCPsU must have a valid Medicaid Fee- for Service USoonerCare Fee-for-ServiceU contract as well as a Uan exercisedU SoonerCare UChoiceU contract UaddendumU. Additionally, all PCP/CMs UPCPsU, excluding Provider or Physician Groups, must agree to accept a minimum capacity of patients, however this does not guarantee PCP/CMs UPCPsU a minimum patient volume. Primary Care Provider/Case Managers UProvidersU are limited to:
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Examples of Provider or Physician Group in a sentence

  • You may also receive medical care from any licensed Out-of-Network Provider or Physician Group.

  • PCPU" means Primary Care Provider/Case ManagerUProviderU, including a Provider or Physician Group.

  • PCP" means Primary Care Provider/Case Manager Provider, including a Provider or Physician Group.

Related to Provider or Physician Group

  • Primary care physician means a physician qualified to be an attending physician according to ORS 656.005(12)(b)(A) and who is a general practitioner, family practitioner, or internal medicine practitioner.

  • 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.

  • Specialist Physician means a licensed physician who qualifies as an attending physician and who examines a patient at the request of the attending physician or authorized nurse practitioner to aid in evaluation of disability, diagnosis, or provide temporary specialized treatment. A specialist physician may provide specialized treatment for the compensable injury or illness and give advice or an opinion regarding the treatment being rendered, or considered, for a patient’s compensable injury.

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79

  • Mental health provider means a health care provider or a health care facility authorized by state law to provide mental health services.

  • Licensed physician means a person licensed to practice

  • Patient care team physician means a physician who is actively licensed to practice medicine in the

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Participating Durable Medical Equipment Provider means a Durable Medical Equipment Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating physician means a physician licensed in Virginia to practice medicine, who practices

  • 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.

  • 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.

  • Provider group means a medical group, independent

  • Non-Participating Durable Medical Equipment Provider means a Durable Medical Equipment Provider who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Family child care provider means a person who: (a) Provides

  • Mental health services provider means an individual, licensed or unlicensed, who performs or purports to perform mental health services, including a:

  • Qualified medical provider means the same as that term is defined in Section 26-61a-102.

  • 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;

  • 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;

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.

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

  • Medical physicist means a person trained in evaluating the performance of mammography equipment and facility quality assurance programs and who meets the qualifications for a medical physicist set forth in 41.6(3)“c.”

  • Bona fide physician-patient relationship means a treatment or counseling relationship between a physician and patient in which all of the following are present:

  • child care element of working tax credit means the element of working tax credit prescribed under section 12 of the Tax Credits Act 2002 (child care element).