Provider Network Lists Clause Samples

The Provider Network Lists clause defines the requirement for maintaining and providing up-to-date lists of healthcare providers that are part of a health plan's network. Typically, this clause obligates the insurer or plan administrator to supply accurate and current information about participating doctors, hospitals, and other medical facilities to plan members, often through online directories or printed materials. By ensuring that members have access to reliable provider information, this clause helps prevent confusion, supports informed decision-making, and reduces the risk of members inadvertently seeking care from out-of-network providers.
Provider Network Lists. The Contractor agrees to provide EOHHS quarterly with a list of all its participating providers, including its behavioral health and substance use disorder providers, with whom regular referral arrangements exist. This list must include a separate list of PCPs who have adequate capacity to accept members. In addition, a list will be provided quarterly that includes designation of language capability of the provider and physical accessibility of the provider’s location, as well as applicable addresses and telephone numbers.
View SourceView Similar (19)
Provider Network Lists. Contractor agrees to provide the State quarterly with a list of all its participating providers, including its mental health and substance abuse providers, with whom regular referral arrangements exist. This list must include a separate list of PCPs who have adequate capacity to accept members. In addition, a list shall be provided quarterly that includes designation of language capability of the provider and physical accessibility of the provider’s location, as well as applicable addresses and telephone numbers.
View Source
Provider Network Lists. Contractor agrees to provide the State quarterly with a list of all its participating dental providers, including those whose practices are open to additional RIte Smiles members. The list shall be provided quarterly and includes designation of language capability of the provider and physical accessibility of the provider's location, as well as applicable addresses and telephone numbers. The format of data submission will be determined by the State.
View Source

Related to Provider Network Lists

  • Provider Services Charges for the following Services when ordered by a Physician for the treatment of an Injury or Illness.

  • Provider Directory a. The Contractor shall make available in electronic form and, upon request, in paper form, the following information about its network providers: i. The provider’s name as well as any group affiliation; ii. Street address(es); iii. Telephone number(s); iv. Website URL, as appropriate; v. Specialty, as appropriate; vi. Whether the provider will accept new beneficiaries; vii. The provider’s cultural and linguistic capabilities, including languages (including American Sign Language) offered by the provider or a skilled medical interpreter at the provider’s office, and whether the provider has completed cultural competence training; and viii. Whether the provider’s office/facility has accommodations for people with physical disabilities, including offices, exam room(s) and equipment. b. The Contractor shall include the following provider types covered under this Agreement in the provider directory: i. Physicians, including specialists ii. Hospitals

  • NON-NETWORK PROVIDER is a provider that has not entered into a contract with us or any other Blue Cross and Blue Shield plan. For pediatric dental care services, non-network provider is a dentist that has not entered into a contract with us or does not participate in the Dental Coast to Coast Network. For pediatric vision hardware services, a non-network provider is a provider that has not entered into a contract with EyeMed, our vision care service manager.

  • Network Access During its performance of this Contract, Contractor may be granted access to Purchaser’s computer and telecommunication networks (“Networks”). As a condition of Network use, Contractor shall: (a) use the Networks in compliance with all applicable laws, rules, and regulations; (b) use software, protocols, and procedures as directed by Purchaser to access and use the Networks; (c) only access Network locations made available to Contractor by Purchaser; (d) not interfere with or disrupt other users of the Networks;

  • PROVIDER PERSONNEL 1. The parties recognize that the primary value of the Provider to the Department derives directly from its Key Personnel assigned in the performance of this Agreement. Key Personnel are deemed to be those individuals whose résumés were offered by the Provider in the Proposal. Therefore, the parties agree that said Key Personnel shall be assigned in accordance with the time frames in the most recent mutually agreed upon project schedule and work plan, and that no re-deployment or replacement of any Key Personnel may be made without the prior written consent of the Agreement Administrator. Replacement of such personnel, if approved, shall be with personnel of equal or greater abilities and qualifications. 2. The Department shall retain the right to reject any of the Provider's employees whose abilities and qualifications, in the Department's judgment, are not appropriate for the performance of this Agreement. In considering the Provider's employees' abilities and qualifications, the Department shall act reasonably and in good faith. 3. During the course of this Agreement, the Department reserves the right to require the Provider to reassign or otherwise remove any of its employees found unacceptable by the Department. In considering the Provider's employees' acceptability, the Department shall act reasonably and in good faith. 4. In signing this Agreement, the Provider certifies to the best of its knowledge and belief that it, and all persons associated with this Agreement, including any Subcontractors, including persons or corporations who have critical influence on or control over this Agreement, are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any Federal or State department or agency. 5. During the course of this Agreement, the Department reserves the right to require a background check on any of the Provider’s personnel (employees and Subcontractors) that are in any way involved in the performance of this Agreement.