Treating provider means a health care provider who has personally evaluated the patient.
Treating provider means an individual provider who personally renders Medicaid services, or assumes responsibility for rendering Medicaid services through personal supervision, on behalf of a Medicaid group provider. Services furnished by a treating provider are billed by and payment is remitted to the group provider.
Treating provider means a health care provider who has
Examples of Treating provider in a sentence
Treating provider must submit documentation indicating why it would be clinically inappropriate to require the member to meet this criterion and why this requirement should be waived.
Treating provider completes the “Non-Contracted Provider Credentialing Application” so the encounter can be submitted to the Oregon Health Authority (OHA).
Provides valid treating Provider information in the submitted encounter data for listed procedure codes, as required in the most recent version of the STATE document titled, “2011 NPI Treating Provider, NPI Pay-To Provider, PCA Treating provider UMPI/NPI, Lead Screening and ED Utilization Managed Care Withhold Technical Specifications.” If the percentage is 95% or greater, the MCO will receive all ten (10) points.
Treating provider will have established, over-time, a relationship with and knowledge of the individual’s disability.
Treating provider: A person licensed to practice one or more of the following professions: Medicine and surgery, osteopathic medicine and surgery, chiropractic naturopathic physician, podiatry, dentistry, optometry, advanced regis- tered nurse practitioner (ARNP), mental health therapists, and certified medical physician assistants or osteopathic phy- sician assistants.
More Definitions of Treating provider
Treating provider means a covered person's treating health care provider or a facility at which a covered person is receiving treatment, that is removed from or leaves a health carrier's network pursuant to subdivision (1) of this subsection.
Treating provider means a health care provider who has evaluated the individual.
Treating provider means a covered person’s treating health care provider or a facility at which a covered person is receiving treatment, that is removed from or leaves a health carrier’s network. Prohibition of Certain Contract Terms (C.G.S.A. § 38a-477f; C.G.S.A. § 38a-472h) This Agreement shall not contain a provision prohibiting disclosure of (1) billed or allowed amounts, reimbursement rates or out-of- pocket costs, or (2) any data to the all-payer claims database program established under applicable law (19a-755a). Such information may be used to assist consumers and institutional purchasers in making informed decisions regarding their health care and informed choices among health care providers and allow comparisons between prices paid by various health carriers to health care providers. Hold Harmless (C.G.S.A. § 38a-477g) Provider agrees that in no event, including, but not limited to, nonpayment by the health carrier or intermediary, the insolvency of the health carrier or intermediary, or a breach of this Agreement, shall the provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against a covered person or a person (other than the health carrier or intermediary) acting on behalf of the covered person for services provided pursuant to this Agreement. This Agreement does not prohibit the provider from collecting coinsurance, deductibles or copayments, as specifically provided in the evidence of coverage, or fees for uncovered services delivered on a fee-for-service basis to covered persons. Nor does this Agreement prohibit a provider (except for a health care provider who is employed full-time on the staff of a health carrier and has agreed to provide services exclusively to that health carrier’s covered persons and no others) and a covered person from agreeing to continue services solely at the expense of the covered person, as long as the provider has clearly informed the covered person that the health carrier does not cover or continue to cover a specific service or services. Except as provided herein, this Agreement does not prohibit the provider from pursuing any available legal remedy. Insolvency or Cessation of Operations (C.G.S.A. § 38a-477g) In the event of a health carrier or intermediary insolvency or other cessation of operations, the participating provider’s obligation to deliver covered health care services to covered persons without requesting payment from a covered person other than ...
Treating provider means the physician or licensed clinician who is providing the direct care to the Covered Person.
Treating provider means a health care provider who has personally evaluated the patient. 24 Basic Health 2008 Member Handbook Table of Contents Appendix A: Schedule of Benefits “Health outcomes” are results that affect health status as measured by the length or quality (primarily as perceived by the patient) of a person’s life. An intervention is considered to be new if it is not yet in widespread use for the medical condition and patient indications being considered. “New interventions” for which clinical trials have not been conducted because of epidemiological reasons (i.e., rare or new diseases or orphan populations) shall be evaluated on the basis of professional standards of care or expert opinion (see “existing interventions” below). “Scientific evidence” consists primarily of controlled clinical trials that either directly or indirectly demonstrate the effect of the intervention on health outcomes. If controlled clinical trials are not available, observational studies that demonstrate a causal relationship between the intervention and health outcomes can be used. Partially controlled observational studies and uncontrolled clinical series may be suggestive, but do not by themselves demonstrate a causal relationship unless the magnitude of the effect observed exceeds anything that could be explained either by the natural history of the medical condition or potential experimental biases. For “existing interventions,” the scientific evidence should be considered first and, to the greatest extent possible, should be the basis for determinations of “medical necessity.” If no scientific evidence is available, professional standards of care should be considered. If professional standards of care do not exist, or are outdated or contradictory, decisions about existing interventions should be based on expert opinion. Giving priority to scientific evidence does not mean that coverage of existing interventions should be denied in the absence of conclusive scientific evidence. Existing interventions can meet the Basic Health definition of “medical necessity” in the absence of scientific evidence if there is a strong conviction of effectiveness and benefit expressed through up-to-date and consistent professional standards of care or, in the absence of such standards, convincing expert opinion. A level of service, supply, or intervention is considered “cost effective” if the benefits and xxxxx relative to costs represent an economically efficient use of resources for patients with...
Treating provider means a physician or other health care provider who has evaluated the individual.
Treating provider means a Member's treating health care provider or a facility at which a Member is receiving treatment that is removed from or leaves UBH's network. The continuity of care period for a Member who is undergoing an active course of treatment must extend to the earliest of the following: