Res 1988-077 - Laserfiche WebLink

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"Mental Illness" mear,s physical l::or mental corldition having an eml::oti'::onal Ot' psychological origin. "Open Enr~llMent Period" means a Eligibility Period as specified and determined periodically by during which Enrollees may enroll this C"ntract without prQviding Hea 1 th PIa.,..!. perìlJd ¡Jf time subsequent t.J the Initial in the application of the Enrolling Unit the Health Plan and the Enrolling Unit, themselves and Eligible Dependents under evidence of good health satisfactQry to "Pat'ticipai;ir'"lg HI:rspital" means a Hospital which has a Corltract 'Jr an Agreement with Health Plan to provide Health Services to Covered Persons. "Par'ticipating Phat'macy" means a Phar'macy which has entered into a service agreement with Health Plan to provide Pharmacy Services to Covered Persons. "Pat't icipat ing Physician" nteans arlY Part icipat ing Primary Care Physician, Participating Specialist Physician or Psychiatric Primary Provider who has entered into a service agreement with Health Plan to provide Health Services t'J C'Jvet'ed Per'sl:,ns. "Pat'ticipating Pt'imary Care Physician" means- a Participatirlg Physician who is selected by the C,:)Vered Pet'son t:) be respl)nsible for providing Ot' authorizing the Health Services covered under this Contract. The Primary Care Physician may only be a Participating Physician from the medical pt'act ices of fami ly pract ice, obstetrics-gyn,)cology, general internal medici:'"le, 'Jt' pediah'ics. "Par't ici pat ing Pr,)vider" means a Part icipat ing Hospital, Part icipat ing Specialist Physician, Participating Primary Care Physician, Psychiatric Pt'imary Provider, Alcohol Dependency Treatment Facility, and any other health service provider who/which has been approved by Health Plan or with whom Health Plan has contracted to provide Health Services to Covered Persons. "Pa¡'t icipat ÍFlg Special ist Physician" means any physician who has entered int,) a service agreement with Health Plan to prl::!vide specialist care to C,)vered Persons. "Presc~iption Medication" means a drug which can, under federal or state law, be dispensed only pursuant tQ a Prescription Order, or which is a compounded prescription or insulin. "Prescription Order" means the authorizatiQn for Prescription Medication issued by a Pat't icipat i ng PhysicÜm, or non-participat ing physician t'endet'Í ng Health Plan appt'oved referral Ot' emergency Health Services, wh,::! is duly 1 icertsed tc, ma~.e such an authrjt'izat ion in the ,")rdi\"lary course \:.f his or her professional practice. "Psychiatric Primary Provider II means the organization or entity with whom Health Plan contracts with and authorizes to evaluate, diagnose, refer a~d/or provide the Mental Health Services, Drug Abuse and Drug Addiction Detoxification, as covered under the Contract. GM-12-7