Medical Provider Network definition

Medical Provider Network. (“MPN”) means any entity or group of providers approved as a Medical Provider Network by the Administrative Director pursuant to Labor Code sections 4616 to 4616.7 and this article.
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Medical Provider Network or “MPN” means a select entity or group of providers, approved by the Administrative Director, Division of Workers’ Compensation, Department of Industrial Relations, State of California, to treat WC injuries on behalf of a self insured employer or insurance carrier.
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Medical Provider Network. Full PPO Network This Plan uses a specific network of Health Care Providers, called the Full PPO provider network. Providers in this network are called Participating Providers. You pay less for Covered Services when you use a Participating Provider than when you use a Non-Participating Provider. You can find Participating Providers in this network at xxxxxxxxxxxx.xxx. Calendar Year Deductibles (CYD)2 A Calendar Year Deductible (CYD) is the amount a Member pays each Calendar Year before Blue Shield pays for Covered Services under the Plan. Blue Shield pays for some Covered Services before the Calendar Year Deductible is met, as noted in the Benefits chart below. When using a Par- ticipating Provider3 When using a Non- Participating Provider4 Calendar Year medical Deductible Individual coverage $1,000 Family coverage $1,000: individual $3,000: Family $3,000 $3,000: individual $9,000: Family Calendar Year Out-of-Pocket Maximum5 An Out-of-Pocket Maximum is the most a Member will pay for Covered Ser- vices each Calendar Year. Any exceptions are listed in the Notes section at the end of this Summary of Benefits. When using a Partici- pating Provider3 When using any combina- tion of Participating3 or Non-Participating4 Providers Individual coverage $5,500 Family coverage $5,500: individual $11,000: Family $10,000 $10,000: individual $20,000: Family A44633 (01/20) 9 No Annual or Lifetime Dollar Limit Blue Shield of California is an independent member of the Blue Shield Association Under this Plan there is no annual or lifetime dollar limit on the amount Blue Shield will pay for Covered Ser- vices. Benefits6 Your payment When using a Participating Provider3 CYD2 applies When using a Non-Participating Provider4 CYD2 applies Preventive Health Services7 $0 $0 Not covered $0 Preventive Health Services California Prenatal Screening Program Physician services Primary care office visit $35/visit 40%  Specialist care office visit $35/visit 40%  Physician home visit $35/visit 40%  Physician or surgeon services in an outpatient facility 20%  40%  Physician or surgeon services in an inpatient facility 20%  40%  Other professional services Other practitioner office visit Includes nurse practitioners, physician assistants, and therapists. Acupuncture services Up to 20 visits per Member, per Calendar Year. Chiropractic services Up to 20 visits per Member, per Calendar Year. Teladoc consultation Family planning  Counseling, consulting, and education  Injectable contracep...
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Examples of Medical Provider Network in a sentence

  • This Agreement does not constitute a Medical Provider Network (“MPN”).

  • For initial treatment of a non-critical injury, the employee may be taken to an occupational clinic (Risk Management approved list) with the OCFA Medical Provider Network (MPN).

  • Otherwise, the County reserves the right to provide a list of physicians within the County’s Medical Provider Network from which the Association member may select a treating physician for his/her work-related injury/illness.

  • HNU’s Medical Provider Network (MPN) preferred provider is: Kaiser On-The-Job Occupational Health Center 0000 Xxxxxxxx Xxx 000 Oakland, CA 94611 (000) 000-0000 • Refer to form Notice to Employees – Injuries Caused by Work for information about worker’s compensation rights and benefits.

  • If your employer or your employer's insurer does not have a Medical Provider Network, you may be able to change your treating physician to your personal chiropractor or acupuncturist following a work-related injury or illness.

  • Medical Provider Network: Trio ACO HMO Network This Plan uses a specific network of Health Care Providers, called the Trio ACO HMO provider network.

  • This could be the employee's treating Physician, an Agreed to Medical Examiner (AME), Qualified Medical Examiner (QME), Independent Medical Examiner (IME), Medical Provider Network (MPN), or whatever type of medical opinion is necessary to the determination as to the employee's ability to return to work in the employee's current regUlar classification with a reasonable accommodation(s) and/or modification(s) or alternate Position(s).

  • In accordance with the requirements of California Labor Code Section 4616 and Title 8 California Code of Regulations Section 9767.5.1, I hereby acknowledge that I participate in a Medical Provider Network administered by the Inland Empire Foundation for Medical Care/California Foundation for Medical Care.

  • In accordance with the requirements of California Labor Code Section 4616 and Title 8 California Code of Regulations Section 9767.5.1, I hereby acknowledge that I participate in a Medical Provider Network administered by the Inland Empire Foundation for Medical Care/ California Foundation for Medical Care.

  • MPN services include but are not limited to: Medical Provider Network ("MPN"): MPN application and maintenance including initial panel setup and periodic updates.


More Definitions of Medical Provider Network

Medical Provider Network means the network of healthcare specialist, medical providers, and hospitals (each a “Network Provider”) that have entered into Preferred Provider Agreements (each a “Provider Agreement”) with Seller or the Company to provide medical services to Claimants. The Provider Agreement induces Network Providers to provide quality medical care at a competitive price in exchange for the participating in the preferred Medical Provider Network. The definition of “Healthcare Management Business” shall include the subcontracting arrangements with other Healthcare Management Businesses in order to offer broader coverage for the Medical Provider Network. The Healthcare Management Business also includes the credentials, re-credentials, and the careful application review process to ensure that the Network Provider is committed to provide medically appropriate care, and to direct valid insured Claimants to Network Providers.
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Medical Provider Network has the meaning set forth in the definition of “Healthcare Management Business.”
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Related to Medical Provider Network

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

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

  • 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.

  • Internet Service Provider (ISP) means an Enhanced Service Provider (ESP) that provides Internet Services.

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

  • 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.

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • Basic health plan services means that schedule of covered

  • Managed care plan means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with or employed by the health carrier.

  • Network pharmacy means any pharmacy that has an agreement to accept our pharmacy allowance for prescription drugs and diabetic equipment/supplies covered under this agreement. All other pharmacies are NON-NETWORK PHARMACIES. The one exception and for the purpose of specialty Prescription Drugs, only specialty pharmacies that have an agreement to accept our pharmacy allowance are network pharmacies and all others pharmacies are non-network pharmacies.

  • Education service provider means an education management organization, school

  • Service Animal means an animal that is required by a person with a disability for assistance and is certified, in writing, as having been trained by a professional service animal institution to assist a person with a disability and which is properly harnessed in accordance with standards established by a professional service animal institution.

  • Service Provider Personnel means and refers to Service Provider employees or subcontractors hired and maintained to perform Services hereunder.

  • BT Network means the communications network owned or leased by BT and used to provide the Service.

  • 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.

  • Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be:

  • Outpatient hospital services means preventive, diagnostic, therapeutic, observation, rehabilitation, or palliative services provided to an outpatient by or under the direction of a physician, dentist, or other practitioner by an institution that:

  • Provider Service means a Provider’s hosted online services (if any) as described in the Solution Exhibit which is provided by Provider to Customers located in the Territory through remote access via the Internet as part of the BPO Service. A Provider Platform Application shall be considered a Provider 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.

  • 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.

  • Medical personnel means those persons assigned, by a Party to the conflict, exclusively to the medical purposes enumerated under subparagraph (e) or to the administration of medical units or to the operation or administration of medical transports. Such assignments may be either permanent or temporary. The term includes:

  • Child support services means any civil, criminal or administrative action taken by the Division of

  • 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

  • Pharmacy means prescribed drugs and medicines dispensed by a pharmacist and/or travel and allergy vaccines dispensed by a pharmacist or doctor.

  • Medical physicist means a person trained in evaluating the performance of mammography equipment and facility quality assurance programs and who meets the qualifications for a medical physicist set forth in 41.6(3)“c.”

  • Medicare Provider Agreement means an agreement entered into between CMS (or other such entity administering the Medicare program on behalf of the CMS) and a health care provider or supplier, under which such health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.