Provider Networks Clause Samples
The PROVIDER NETWORKS clause defines the requirements and conditions related to the use of networks of service providers, such as healthcare professionals or facilities, that are approved or contracted by a company or insurer. It typically outlines how participants must use these designated providers to receive full benefits, and may specify procedures for accessing out-of-network services, including any additional costs or limitations. This clause ensures that services are delivered through vetted providers, helping to control costs, maintain quality standards, and clarify the scope of covered services for all parties involved.
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Provider Networks. The Contractor shall provide a managed, stable, high-quality network, or networks, of individual and institutional health care providers which supplements the clinical services provided to MHS beneficiaries in MTFs and promotes access, quality, beneficiary satisfaction, and “best value health care” for the Government. (See the ▇▇▇, Appendix B for the definition of “best value health care.”) The network, or networks, shall be sufficient in number, mix, and geographic distribution of fully qualified providers to provide the full scope of benefits for which all Prime enrollees are eligible under this contract, as described in 32 CFR 199.4, 199.5, and 199. I 7. The Contractor shall provide copies of network provider agreements when requested by the Contracting Officer or Contracting Officer’s Representative (COR).
Provider Networks. Florida Blue's Health Care Provider Networks are subject to change and may be modified at any time during the term of this Agreement without notice to or consent of the Group or any Group Member.
Provider Networks. Provider agrees to provide Covered Services to any Member under any Provider Network in which Provider participates pursuant to the terms of this Agreement and any addenda or exhibits attached hereto. Nothing in this Agreement gives Provider the right to participate in any new provider networks or lines of business developed by Regence.
Provider Networks. Blue Cross Blue Shield of Massachusetts
Provider Networks. Florida Blue's Health Care Provider Networks are subject to change and may be modified at any time during the term of this Agreement without notice to or consent of the Group or any Group Member.
A. Premium rates effective: October 1, 2014 through September 30, 2015 Blue Options Plan 03769: Single: $670.91 E/S: $1,389.50 E/C: $1,261.95 Family: Blue Options Plans 05192-05193: Single: $2,131.25 $429.76 E/S: $889.58 E/C: $807.94 Blue Care Plan 45: Family: Single: $1,364.47 $547.92 E/S: $1,134.20 E/C: $1,030.08 Blue Care Plan 60: Family: Single: $1,739.64 $614.96 E/S: $1,272.98 E/C: $1,156.13 Family: $1,952.50
B. Administrative charges effective: October 1, 2014 through September 30, 2016
Provider Networks. BCBSF's Health Care Provider Networks are subject to change and may be modified at any time during the term of this Agreement without notice to or consent of the Group or any Group Member. By By Name ▇▇▇▇▇ ▇▇▇▇▇▇ Name (Typed) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Title Vice President and Chief Underwriting Officer Title Superintendent A. Premium rates effective: January 1, 2013 through December 31, 2013 BOPT 3748 BCH 706 BOPT O3769 BOPT O5180/05181 Single $606.86 $673.08 $552.84 $494.60 EE + 1 $1,359.62 $1,507.98 $1,238.62 $1,108.10 Family $1,728.76 $1,917.40 $1,574.90 $1,408.94 SP/Child $752.76 $834.90 $685.78 $613.50 SP & Child/(ren) $1,121.90 $1,244.32 $1,022.06 $914.34
Provider Networks