Specialty Providers definition

Specialty Providers means health care providers such as home health, hospice, mental health, physicians, pharmacists and hospitals.
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Specialty Providers means specially qualified masters level behavioral health professionals who are a) certified by the Arizona Board of Behavioral Health Examiners as a Certified Independent Social Worker (CISW), Certified Professional Counselor (CPC), or Certified Marriage and Family Therapist (CMFT); and b) credentialed by the RBHA or its designee as having two years training or experience in a specialty area treating children with certain behavioral health needs or problems; and c) contracted with the RBHA or its designee and registered with AHCCCS.
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Specialty Providers means specially qualified masters level behavioral health professionals
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Examples of Specialty Providers in a sentence

  • Corrective Action Plans (CAPs) are required for those PPGs/ Specialty Providers with less than 90% compliance .PPGs/Specialty Providers with deficiencies or CAPs will be monitored according to L .A .

  • Care’s directly contracted PPGs/ Specialty Providers are performed as prescribed in the UM Delegation Oversight Plan as approved by the UM Committee .

  • Care reserves the right to continue to delegate UM to the PPGs/ Specialty Providers if they meet L .A .

  • Overview of Provider Services Department 59 Provider Web Portal 59 Re-credentialing 60 PCP Responsibilities 60 PCP Contract Terminations 60 Specialty Providers 61 Out-of-network providers 61 Second Opinion.

  • Autism Support Brokers assist family members in employing Autism Specialty Providers who deliver waiver services to the participant.

  • Specialty Providers are providers that specialize in a specific service, specific disability area, or both.

  • The CONTRACTOR shall ensure that PCPs successfully identify and refer Members to Specialty Providers as Medically Necessary.

  • The CONTRACTOR shall ensure that LTS providers successfully identify and refer Members to PCPs for referral to Specialty Providers as Medically Necessary.

  • All contracted Primary Care and key high-volume Specialty Providers who have been identified as routinely directly or indirectly facilitating and/or providing Medicare Part C or D benefits for Molina Members will be required to complete the Model of Care training and provide attestation of training completion.

  • AHCCCS requires the reporting of all patient encounters for all services provided, including capitated services provided by Primary Care Providers (PCP), Specialty Providers, Ancillary Service Providers and Facilities.

Related to Specialty Providers

  • Third Party Providers or “TPPs” means any payment service provider that provides payment services to you or someone else that concerns the Account, for example, an AISP (described in Clause 1(c) below).

  • Providers means individuals or organizations --------- licensed to practice dentistry (including specialists) as well as other dental professionals who provide ancillary reimbursable dental services.

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

  • 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.

  • Specialty means a broad, population-based focus of study encompassing the common health-related problems of a particular group of patients and the likely co-morbidities, interventions, and responses to those problems.

  • Provider is any individual or company that provides professional or technical services.

  • SPECIALTY HOSPITAL means a hospital or the specialty unit of a general hospital that is licensed by the state. It must be designed to care for patients with injuries or special illnesses. This includes, but is not limited to, a long-term acute care unit, an acute mental health or acute short-term rehabilitation unit or hospital. • convalescent home; • rest home; • nursing home; • home for the aged; • school and college infirmary; • residential treatment facility; • long-term care facility; • urgent care center or freestanding ambulatory surgical center; • facility providing mainly custodial, educational or rehabilitative care; or • a section of a hospital used for custodial, educational or rehabilitative care, even if accredited by the JCAHO or listed in the AHA directory.

  • 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.

  • Data Providers means pricing vendors, analytics providers, brokers, dealers, investment managers, Authorized Persons, Subcustodians, Depositories and any other Person providing Market Data to the Custodian.

  • Third Party Provider means licensors, subcontractors and suppliers of BNYM furnishing the Third Party Products.

  • Non-Participating Home Infusion Therapy Provider means a Home Infusion Therapy 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.

  • Pharmacy services means the practice of pharmacy as defined in chapter 18.64 RCW and includes any drugs or devices as defined in chapter 18.64 RCW.

  • Emergency medical care provider means an individual who has been trained to provide emergency and nonemergency medical care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic, paramedic specialist or other certification levels recognized by the department before 1984 and who has been issued a certificate by the department.

  • Corporate Services Provider means Computershare Trust Company of Canada, a trust company formed under the laws of Canada, as corporate services provider to the Liquidation GP under the Corporate Services Agreement, together with any successor corporate services provider appointed from time to time;

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

  • Specialty fertilizer means a fertilizer distributed primarily for nonfarm use.

  • Pharmacy care means medications prescribed by a licensed physician and any health-related

  • ProviderOne or “P1” means the system commonly referred to as the Medicaid Management Information System (MMIS), and is the federally approved system used by the Washington Medicaid program to pay provider claims for goods and services authorized under the State Plan. The MMIS is certified by CMS and is the primary information system used by HCA to pay for health care.

  • Emergency medical services or “EMS” means an integrated medical care delivery system to provide emergency and nonemergency medical care at the scene or during out-of-hospital patient transportation in an ambulance.

  • 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.

  • 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.

  • Hospitals means either an employee when engaged in repairs, demolition and / or maintenance in any block or portion of a hospital used for the care or treatment of patients suffering from infections or contagious diseases or when an employee is working inside a morgue in which one (1) or more dead bodies are not in refrigeration. Inclement weather will mean the existence of rain or abnormal climatic conditions (whether they be those of hail, snow, cold, high wind, severe dust storm, extreme high temperature or the like or any combination thereof) by virtue of which it is either not reasonable or not safe for employees to continue working whilst the same prevail. Industry allowance means an allowance to compensate for the following disabilities associated with construction work: Insulation includes handling charcoal, pumice, granulated cork, silicate of cotton, insulwool, slag wool, limpet fibre, vermiculite or other recognise insulating materials of a like nature, associated with similar disability in its use. This will also apply where an employee is working in the immediate vicinity who is affected by the use of such materials. Irrigation installer means an employee employed or usually employed in executing any irrigation plumbing. Without limiting the generality of the foregoing such work will include the following: Lagger means a person that insulates or clads ducts, pipes, valves or any other thing used in or in connection with the plumbing and air conditioning industry for the protection of thermal and or acoustics.

  • Participating Home Infusion Therapy Provider means a Home Infusion Therapy 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.

  • Financial Services Provider means any Lender and any other provider of financial services or products;

  • 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.

  • 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