Eligible Provider

Eligible Provider

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In the context of healthcare, an “eligible provider” typically refers to a healthcare provider who is eligible to participate in certain programs or to receive certain benefits, often from government healthcare programs. The specific criteria that determine eligibility can vary significantly depending on the context.

For example, in the United States, under the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs established by the Health Information Technology for Economic and Clinical Health (HITECH) Act, eligible providers are those that meet certain criteria and can thus receive incentive payments for adopting, implementing, upgrading, or demonstrating “meaningful use” of certified EHR technology.

In these programs, eligible providers may include:

  • Doctors of Medicine or Osteopathy
  • Doctors of Dental Surgery or Dental Medicine
  • Doctors of Podiatric Medicine
  • Doctors of Optometry
  • Chiropractors
  • Hospitals and Critical Access Hospitals (CAHs)
  • Medicaid-eligible professionals, including Physicians, Nurse Practitioners, Certified Nurse-Midwives, Dentists, and some Physician Assistants.

It’s important to note that the term “eligible provider” is broad and can apply to different types of healthcare providers in different contexts. The specific eligibility criteria can vary based on factors like the provider’s specialty, the types of patients they see, and the services they provide. Always refer to the specific program or context to understand what constitutes an “eligible provider.”

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