National Provider Identifier Registration

For FiscalAgent Use: _ National Provider Identifier Registration All HIPAA-coveredhealthcare providers, whether they are individuals or organizations, must obtain a National Provider Identifier (NPI) to identify themselves in the HIPAA standard transactions.

Special Open Enrollment

If any state laws mandate other liability calculation methods, includinga surcharge, we would then calculate your liability for any coveredhealthcare services according to applicable law. B. Non-Participating Healthcare Providers Outside Our Service Area Member Liability Calculation When covered ...

Covered Entity Charts

2 Background: The Administrative Simplification standards adoptedbyHHSundertheHealthInsurancePortabilityandAccountabilityActof1996 (HIP AA) apply toanyentitytha tis:-ahealthcareproviderthatconductscertaintransactionsinelectronic form (calledherea"coveredhealthcare provider") ,-ahealthcare ...

Effective July 1, 2008

Whenever you access coveredhealthcare services outside our service area and the claim is processed through the BlueCard Program, the amount you pay for coveredhealthcare services is calculated based on the lower of:  The billed covered charges for your covered services; or  The negotiated price that ...

Benefit Summary Table

... of copayments thatamemberor family is required to pay in a calendar year Prior authorization-authorization received from Hometown Health prior to receiving covered services Participating providers-healthcare providers with whom Hometown Health has contracted to provide discounted, coveredhealthcare ...

DDH Australian Small Companies Fund

This issue has now been resolved with Andrew Hodge moving from large caps (previously coveredhealthcare and gaming) to small caps as of September 2006 following the arrival of anadditonal resource within large companies (Stephen Kench).

Dear Clinician:

B onnieDarves, who updated the 2007 edition of this guide, is an independent writer based in Lake Oswego, Oregon, who has coveredhealthcare business, research and clinical care issues for more than a decade.

HealthSpring PPO Plan Provider Directory

As a member of our plan, you may get coveredhealthcare services from a plan provider ora non-plan provider. When you geta service from a plan provider, this is called an "in-network"service.

Effectiveness of public health interventions for increasing ...

Of these, three reviews coveredhealthcare settings (Edenet al., 2002; Petrellaand Lattanzio, 2002; Smithet al., 2002). One review examined the workplace (Proper et al., 2003) and two reviews lookedat older adults (Vander Bijet al., 2002; Connet al., 2003).

Ochsner Health System

Within Peoples Health Provider Network You can also access coveredhealthcare services from any provider in your Peoples Health plan network. Out of Peoples Health Network Out-of-network services may not be covered or may have a higher cost.

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