Examples of Provider Policies in a sentence
If IPA or a Member Physician admits a Subscriber to a Hospital for Emergency Services, IPA shall notify PacifiCare of such admission within the time frames as required in the PacifiCare Provider Policies and Procedures Manual, attached hereto as Attachment D and incorporated in full herein by reference.
This report shall be as described in the PacifiCare Provider Policies and Procedures Manual.
PacifiCare may require transfer of Subscribers assigned to IPA for any reason; or, IPA may request transfer of Subscribers assigned to it by PacifiCare to other IPAs for cause or if the capacity of IPA is overburdened so that the provision of Medical Services as required by this Agreement is affected; all such transfers shall be consistent with the PacifiCare Provider Policies and Procedures Manual.
Nevertheless, PacifiCare may require transfer of Subscribers assigned to IPA for any reason; or, IPA may request transfer of Subscribers assigned to it by PacifiCare to other IPAs for cause or if the capacity of IPA is overburdened so that the provision of Medical Services as required by this Agreement is affected; all such transfers shall be consistent with the PacifiCare Provider Policies and Procedures Manual.
Provider Policies and Procedures Repository • Web access to Provider Policies and Procedures (PnP) portal • Ability to add, change, delete Recipient specific documents on portal as needed NOTE: Included in Schedule 3, Information Technology Services.
MANAGER shall enlist IPA to (a) educate IPA Physicians and other IPA Providers in IPA’s policies and procedures; (b) develop and distribute appropriate IPA forms to IPA Providers; (c) develop and update IPA Provider Policies and Procedures Manual; (d) develop and implement health education programs for Enrollees; and (e) assist IPA to respond to Enrollee complaints or grievances.
IPA must submit a claim in accordance with the procedures specified in the PacifiCare Provider Policies and Procedures Manual.
The methodology for determining IPA's Capitation Payment is more fully set forth in the PacifiCare Provider Policies and Procedures Manual in Attachment D hereto.
PacifiCare may provide notice to amend the Delegated Section of the PacifiCare Provider Policies and Procedures Manual and any other standards or procedures applicable to Medical Group or its Medical Group Physicians by providing Medical Group thirty (30) day prior written notice of such amendments.
IPA agrees to perform its duties under this Agreement in a manner consistent with the reasonable administrative guidelines provided by PacifiCare, in its Provider Policies and Procedures Manual, attached hereto as Attachment D and incorporated in full herein by reference.