A hospital, other institutional provider or health facility, ancillary provider, physician, licensed practitioner, medical group or independent practice association, or similar entity that has an agreement with UNICARE and/or one or more of its affiliates to provide covered services for prospectively determined rates.
A doctor or hospital that agrees to accept your insurance payment for covered services as payment in full, minus your deductibles, co-pays and coinsurance amounts.
A provider who participates with a network or a Blue Cross and Blue Shield Plan.
A medical professional, service or institutions employed by, or under contract to provide health care services to member insured.
A health care provider who has an agreement with us to provide benefits to our members.
A health care professional or facility that has a written participation agreement with an insurance plan. For Medicare, a physician who signs a participation agreement, agrees to accept assignment of all Medicare claims for a period of one year. Frequently referred as Par.
A participating provider holds a contract with an insurer that requires the provider to accept the insurer's payment for a service as payment in full, after deductibles, coinsurances, or copays.
A hospital, pharmacy, physician or ancillary services provider who has contracted with a health plan to provide medical services for a determined fee or payment.
Any provider who is a member of a benefit plan's network.
Ohio Med. A physician or other professional provider who has an agreement with Medical Mutual about payment for covered services. A participating provider will not balance-bill you and will file claims on your behalf. A participating provider is not necessarily a network provider.
Providers who contract with PacifiCare to provide covered services to members.
a certified provider who is said to "accept TRICARE," "accept assignment," or "accept TRICARE on assignment
a CHAMPUS-authorized provider who has signed an agreement or indicated "accept assignment" on a claims form
a dentist who has agreed to participate and provide dental services to plan members at a lower, preferred schedule of fees
a dentist who has agreed to participate in a discount dental plan and to provide dental services to plan members at lower prices
a physician or other Provider who has agreed to accept GHI's scheduled or negotiated rates as payment in full or covered services (except for any applicable co-payments, co-insurance or deductibles)
Any physician, hospital, pharmacy, laboratory or other diagnostic center under contract with the health plan to provide services to members at a specified cost. Find an Optima Health participating provider.
A physician who is enrolled in a network of physicians associated with a particular health plan.
A doctor who participates in the approved plan and accepts the usual customary and reasonable charges as payment in full.
A provider who agrees to "accept assignment" for all services provided to all Medicare patients for the following year. Because "clinical psychologists" MUST accept assignment, they are considered "participating providers".
A physician may enter into a contract with a specific insurance company or program, and by doing so, agrees to abide by certain rules and regulations set forth by that particular third party payer. There are usually pros and cons to such a contract. Some of the more common pros are that the claims will be processed faster, the benefits will be paid directly to the physician, and pre-addressed, pre-numbered forms will be provided by the payer. Cons include that the provider must accept the amount of benefits paid as payment in full and is not allowed to bill the patient for the balance (aside from any deductibles and coinsurance).
A provider who has contracted to provide medical services to an insurer's covered plan members. This term could include doctors, hospitals, pharmacies, home health care companies, and some other health care facilities if they have contractually accepted the terms of a specific insurance plan.
A health care provider (e.g., doctor, psychologist, hospital) who agrees to accept the terms, conditions and allowable payments of an insurer.
A participating physician, participating hospital, or other licensed, certified or registered health facility or provider which has entered into an agreement with a plan, John Muir Physician Network to provide covered services to enrollees.
A physician, hospital, pharmacy, or other provider that has a contract to provide covered services to L.A. Care Members.
A healthcare provider such as a physician, skilled nursing facility, home health agency, laboratory etc, who has an agreement withMagnaCare to provide covered services to its members.
See I n-network provider.
A provider who has contracted with a health care plan, such as an HMO or PPO, to provide medical services to the health care plan’s enrollees. The provider has contracted to accept the terms and conditions set forth by the health care plan.
a provider who has a contractual relationship with the claims administrator for the coverage option in which you are enrolled.
A healthcare provider who participates through a contractual arrangement with a healthcare service contractor, HMO, PPO, IPA, or other managed care organization.
A provider of health care who has contracted with a health plan to deliver medical services to plan members.
"Provider" is the general term we use for doctors, other health care professionals, hospitals, and other health care facilities that are licensed or certified by Medicare and by the State to provide health care services. We call them "participating providers" when they have an agreement with Secure Health to accept our payment as payment in full, and in some cases to coordinate as well as provide covered services to members of Secure Health. Secure Health pays plan providers based on the agreements it has with the providers.
Any provider who has an agreement with the carrier to provide covered services.
A doctor or other health care provider who agrees to "takes assignment"—accept Medicare's approved amount as payment in full. Any doctor who is a "participating provider" in the Medicare program always takes assignment. Participating providers may not charge you more than Medicare's approved amount. If you have Original Medicare, you can save money if you see a doctor who takes assignment (you still pay your coinsurance).
A Provider of healthcare services, such as a Physician, Hospital, Skilled Nursing Facility, Home Health Agency, pharmacy, laboratory, ambulance company, X-ray Facility or other licensed Health Professional, which has contracted with the Plan or affiliated IPA to provide Covered Services to Members in accordance with the plan provisions.
A contracted Ophthalmologist, Optician, or Optometrist who accepts benefit allowances as payment-in-full for covered services.
a provider who has a contract with a particular health plan to provide medical services to covered persons. A non-participating provider is a provider that has not contracted with the carrier or health plan to be a participating provider of healthcare. The slang term is Par.
A provider who is under contract with the health plan to provide services. This includes not only physicians and hospitals, but also optometrists, pharmacies and other designated individuals and services.
A facility or other provider that contracts with the Blues to provide care or services to members under specific reimbursement terms.
A provider who has agreed to accept a certain level of payment from an indemnity plan for treating the plan's insureds. The provider may be a hospital, pharmacy, other facility or a physician who has contractually accepted the terms and conditions as set forth by the health plan. Insureds may not be required to use participating providers, but usually pay more if they do not.
a medical provider who has been contracted to render medical services or supplies to insureds at a pre-negotiated fee. Providers include hospitals, physicians, and other medical facilities.
Any provider licensed in the state of provision and contracted with an insurer.
A Medicare term used to describe an agreement by a doctor to accept Medicare's approved amount as payment in full. Participating providers may not charge you more than Medicare's approved amount.
provider who has contracted with the health plan to deliver medical services to covered persons. The provider may be a hospital, other facility or a physician who has contractually accepted the terms and conditions as set forth by the health plan.
A physician, hospital, pharmacy, laboratory or other appropriately licensed facility or provider of health care services or supplies that has entered into an agreement with a managed care entity to provide services or supplies to a patient enrolled in a health benefit plan.
A doctor or supplier who agrees to accept assignment on all Medicare claims. These doctors or suppliers may bill you only for Medicare deductible and/or cost shares.
A doctor or supplier who agrees to accept the TRICARE allowable charge as full payment. These doctors or suppliers may bill you only for TRICARE deductible and/or cost shares.
a Hospital, Physician, home health agency, ambulance service, laboratory or other healthcare provider under contract with HPS. These providers are authorized in advance by HPS to provide specific services to Members. Unless otherwise specified, Participating Providers have independent professional businesses, exercise independent judgement and are independent contractors with HPS.
A physician or other medical provider has agreed to accept a set fee for services provided to members of a specific health plan. They are deemed to be "in-network".
An appropriately licensed facility or individual of health care services or supplies, that has entered into an agreement with a managed care entity to provide eligible services or supplies to a Member enrolled in a Health Benefit Plan.
Individual physicians, hospitals and professional health care providers who have a contract with your insurance company to provide services to its members at a discounted rate. It is possible for a provider to be participating but still be out-of-network.
An ophthalmologist, optometrist or optician who accepts benefit allowances as payment-in-full for covered services of the enrollee. All other services and benefit overages are the patients responsibility.
A provider who agrees to accept assignment (Medicare-allowed amount) on all Medicare claims, but can, on a case-by-case basis, waive liability.
The dentists and other providers that are in the network of the dental plan.
Medical providers that have agreed to accept set fees for services to members of a specific health plan or network. These providers are referred to as being “in network.
Any Provider who has an agreement with the Plan to accept a negotiated fee rate.
Any physician, hospital, skilled nursing facility, or other individual or entity involved in the delivery of health care or ancillary services which contracts to provide Covered Services to Members.
A provider who has agreed to contract with a managed care program to provide eligible services to covered persons.
An endodontist who signs a contractual agreement with the dental insurance carrier to provide care to eligible members.
A health care provider approved by Medicare to participate in the program and receive benefit payments directly from carriers or fiscal intermediaries.