Referral Provider definition

Referral Provider means a provider, who is not the enrollee’s PCP, to whom an enrollee is referred for covered services.
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Referral Provider means a provider, who is not the enrollee’s PCP, to whom an enrollee is referred for covered services.‌
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Referral Provider means a Contracted Physician who is professionally qualified to practice his/her designated specialty and whose agreement with HPSM includes responsibility for providing Covered Services in his/her designated specialty.
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Examples of Referral Provider in a sentence

  • Because telephone central office boundaries do not necessarily match the boundaries used by an Approved Community Information and Referral Provider, providing 211 Service for the entire area served by a central office may result in the Approved Community Information and Referral Service Provider receiving calls from geographical areas it does not serve.

  • If a Referral Provider is higher quality and/or lower cost, this component of the program should result in their getting more referrals from PCPs. The converse should be true if Referral Providers are lower quality and/or higher cost.

  • Information and Referral Provider (I&R Provider) is an organization which helps match people with requested services.

  • The Company can only provide 2-1-1 Service to one specified telephone number as provided to it by the Approved Information and Service Referral Provider.

  • De EU is op grond van artikel 192, eerste lid, jo 191, eerste lid, VWEU bevoegd om activiteiten vast te stellen ter behoud, bescherming en verbetering van de kwaliteit van het milieu, ter bescherming van de gezondheid van de mens, voor een behoedzaam en rationeel gebruik van de natuurlijke hulpbronnen, en ter bevordering op internationaal vlak van maatregelen om het hoofd te bieden aan regionale of mondiale milieuproblemen, en in het bijzonder de bestrijding van klimaatverandering.

  • Aging-state options, service plan delivery, service orders); Referral (Provider, Recipient); IEB (Independent Enrollment Broker); OMNIA (LOCAs); McKesson CERMe (guideline for home health/rehab/inpatient/DME/prior authorization); RAC and UPIC contractor; Labor and Industry (L&I) Employment data set; State Corporation Bureau.

  • Select the provider under Referral Provider Quicklist to make a referral to the priority list.

  • Your recommendations could includereferring the employee to the Employee Assistance Program (EAP) or Referral Provider for professional help.

  • Compared to the end of 2015:• traffic on its website doubled, reaching between 12,000 and 16,000 monthly visits;• requests and questions sent by email increased from 10 to approximately 40 per week;• the average number of phone calls per day increased from five to between 20 and 40, with as many as 80 calls per day.

  • Referral Provider shall be liable for money damages suffered by Company resulting from such circumvention.


More Definitions of Referral Provider

Referral Provider means a Participating Provider who performs Covered Services that are not Primary Care Covered Services, within their designated specialty(s) as defined in their Provider Agreement with COMPANY.
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Referral Provider means the Party that delivers a Proposed Referral.
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Related to Referral Provider

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

  • Professional Provider means a Physician, Dentist, Podiatrist, Psychologist, Chiropractor, Optometrist or any Provider designated by the Claim Administrator or another Blue Cross and/or Blue Shield Plan.

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

  • Account Information Service Provider means a payment service provider pursuing business activities as referred to in point (8) of Annex I;

  • Participating provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • Data Provider means a Participant that is registered to provide information to GS1 South Africa for use through the Verified by GS1 Services.

  • 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.

  • Individual provider means an individual provider as defined

  • 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.

  • Participating Orthotic Provider means an Orthotic 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.

  • account information service means an online service to provide consolidated information on one or more payment accounts held by the payment service user with either another payment service provider or with more than one payment service provider;

  • Data Services The Customer will receive a discount equal to 25% for the following Data Services: Access: Standard VBS2 Guide local loop charges for DS-1 Access and DS-3 Access Service.

  • Hosting Services means the provision, administration, and maintenance of servers and related equipment, the provision of bandwidth at the hosting facility, and the operation of the Application for access by Customer Users to be provided by the relevant hosting service provider.

  • 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.

  • financial service provider means a person engaged in the business of providing financial services in terms of authorisation issued or registration granted by a financial sector regulator;

  • Emergency medical services provider means a person who has received formal training in prehospital and emergency care, and is licensed to attend any person who is ill or injured or who has a disability. Police officers, firefighters, funeral home employees and other persons serving in a dual capacity one of which meets the definition of “emergency medical services provider” are “emergency medical services providers” within the meaning of this chapter.

  • Self-Administration of Medication means the individual manages and takes his or her own medication, identifies his or her medication and the times and methods of administration, places the medication internally in or externally on his or her own body without staff assistance upon written order of a physician, and safely maintains the medication without supervision.

  • Information Recipients has the meaning stated in Section 4.9(a).