Prepaid Capitation definition

Prepaid Capitation means the aggregate of all prepaid capitation amounts paid in advance with respect to the Reinsured Policies determined in accordance with SAP and appropriately includable on line 22 of the Assets page of the 2000 NAIC Annual Statement Blank, on line 24 of the Assets page of the 2001 NAIC Annual Statement Blank, or in comparable line items on successor NAIC Annual Statement Blanks, in each case whether or not such prepaid capitation amounts are admitted assets for statutory reporting purposes.
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Prepaid Capitation means an annual fixed premium per person paid in advance for a specified set of comprehensive health benefits.
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Prepaid Capitation means an arrangement whereby the dentist providing services is compensated through capitation on the basis of the presence of an enrollee regardless of whether services are provided.]
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Examples of Prepaid Capitation in a sentence

  • Prepaid capitation will include all prepayments made to one or more health care providers, in any form and for any arrangement, in exchange for one or more covered health care services to be rendered referred or otherwise arranged by such providers and by its participating providers.

  • Prepaid capitation or premium payments made under such contracts shall not exceed payments made to other third party payers for comparable services and similar benefit conditions.

  • Prepaid capitation or premium payments made under suchcontracts shall not exceed payments made to other third party payers for comparable services and similar benefit conditions.

  • Prepaid capitation versus fee- for-service reimbursement in a Medicaid population.

Related to Prepaid Capitation

  • Capitation means the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made to the Contractor for the performance of all of the Contractor’s duties and obligations pursuant to this Contract.

  • Capitation rate means the fee the department pays monthly to a participating health or dental plan for each enrollee for the provision of covered medical or dental services whether or not the enrollee received services during the month for which the fee is intended.

  • Prepaid Card means the MasterCard Prepaid Card that you have purchased from us;

  • Prepaid wireless calling service means a telecommunications service:

  • Capitation Payment means a payment the STATE makes periodically to the MCO for each Enrollee covered under the Contract for the provision of services as defined in Article 6 regardless of whether the Enrollee receives these services during the period covered by the payment.

  • Prepaid calling service means a telecommunications service:

  • Poverty line means the nonfarm federal poverty line for the continental United States, as defined by the federal department of labor under 42 USC 9902 (2).

  • Balance billing means charging or collecting an amount in excess of the Medicaid, Medicare, or contracted reimbursement rate for services covered under a Medicaid, Medicare or employer sponsored beneficiary’s plan. “Balance Billing” does not include charging or collecting deductibles or copayments and coinsurance required by the beneficiary’s plan.

  • Skilled Nursing Care means services requiring the skill, training or supervision of licensed nursing personnel.

  • Mail order pharmacy means a pharmacy licensed by this

  • Prepaid contract means any Contract that has terminated or been prepaid in full prior to its scheduled expiration date (including because of a Casualty Loss), other than a Defaulted Contract.

  • Network Availability means the capability of the equipment to resume functions after a remotely initiated trigger has been detected by a network port;

  • Diameter at breast height (dbh) means the diameter of a tree at 4 1/2 feet above the ground measured from the uphill side.

  • Unsubsidized Xxxxxxxx Loan means a Loan made pursuant to Section 428H of the Higher Education Act.

  • Busy Line Verification (BLV means a service whereby an End User requests an operator to confirm the busy status of a line.

  • payment initiation service means a service to initiate a payment order at the request of the payment service user with respect to a payment account held at another payment service provider;

  • Subsidized Xxxxxxxx Loan means a Loan for which the interest rate is governed by Section 427A(a) or 427A(d) of the Higher Education Act.

  • Medicaid means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of Title XIX of the Social Security Act, codified at 42 U.S.C. 1396 et seq.

  • Intermodal Rail Yard means a rail facility in which cargo is transferred from drayage truck to train or vice-versa.

  • Adult day care means a program for six (6) or more individuals, of social and health-related services provided during the day in a community group setting for the purpose of supporting frail, impaired elderly or other disabled adults who can benefit from care in a group setting outside the home.

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

  • Vapor balance system means a combination of pipes or hoses which create a closed system between the vapor spaces of an unloading tank and a receiving tank such that vapors displaced from the receiving tank are transferred to the tank being unloaded.

  • Voice mail service means an ancillary service that enables the customer to store, send or receive recorded messages. Voice mail service does not include any vertical services that the customer may be required to have in order to utilize the voice mail service.

  • Skilled Nursing Facility means an institution or part thereof that is licensed as a Skilled Nursing Facility by the State of Florida, and is accredited as a Skilled Nursing Facility by The Joint Commission or recognized as a Skilled Nursing Facility by the Secretary of Health and Human Services of the United States under Medicare.

  • Billing involves the provision of appropriate usage data by one Telecommunications Carrier to another to facilitate Customer Billing with attendant acknowledgments and status reports. It also involves the exchange of information between Telecommunications Carriers to process claims and adjustments.

  • Earned value management system means an earned value management system that complies with the earned value management system guidelines in the ANSI/EIA-748.