CALCULATIONS FOR INPATIENT SERVICES REIMBURSEMENT. DRG Reimbursement calculation: (100% Base Rate x DRG Weight) + ICR Stop Loss Reimbursement calculation: Billed Charge x cost-to-charge ratio (determined by HSD) x percentage (determined by HSD)
CALCULATIONS FOR INPATIENT SERVICES REIMBURSEMENT Sample Clauses
Related to CALCULATIONS FOR INPATIENT SERVICES REIMBURSEMENT
Inpatient Services Hospital This plan covers services provided while inpatient in a general or specialty hospital including, but not limited to the following: • anesthesia; • diagnostic tests and lab services; • dialysis; • drugs; • intensive care/coronary care; • nursing care; • physical, occupational, speech and respiratory therapies; • physician’s services while hospitalized; • radiation therapy; • surgery related services; and • room and board. Notify us if you are admitted from the emergency room to a hospital that is not in our network. Our Customer Service Department can assist you with any questions you may have about your coverage. Rehabilitation Facility This plan covers rehabilitation services received in a general hospital or specialty hospital. Coverage is limited to the number of days shown in the Summary of Medical Benefits.
Outpatient Services The following services are covered only at the Primary Care Provider’s office[selected by a [Member], or elsewhere [upon prior written Referral by a [Member]'s Primary Care Provider ]:
Compensation and Billing 4.1 If you are not an embedded retail generator, you agree that, subject to any applicable law:
Educational Reimbursement SECTION 1. The purpose of this Article is to xxxxxx a learning environment and provide educational opportunities that are mutually beneficial to the employees and the County and will encourage eligible employees to participate in education programs which will further their skills and knowledge for use in their current position or for use in a possible future position of greater responsibility. The Educational Reimbursement Program shall be a plan as provided for in Section 127 of the Internal Revenue Code of 1986, as amended (the “Code”) and shall be construed consistently with the requirements of Section 127. Amounts paid for tuition reimbursement meeting the requirements of Section 127 of the IRS Tax Code are not included in an Employee’s income or subject to income tax withholding up to a maximum of $5,250 annually. If subsequent tax law changes fail to continue the tax-free treatment, or in any way modify its treatment, appropriate adjustments in tax withholding will be made from the effective date of the change. This Article does not apply to training seminars, conferences, workshops, etc.
Outpatient emergency and urgicenter services within the service area The emergency room copay applies to all outpatient emergency visits that do not result in hospital admission within twenty-four (24) hours. The urgicenter copay is the same as the primary care clinic office visit copay.
Professional Services Fees You agree to pay us the professional services fees in the amounts set forth in the Investment Summary. Those amounts are payable in accordance with our Invoicing and Payment Policy. You acknowledge that the fees stated in the Investment Summary are good-faith estimates of the amount of time and materials required for your implementation. We will bill you the actual fees incurred based on the in-scope services provided to you. Any discrepancies in the total values set forth in the Investment Summary will be resolved by multiplying the applicable hourly rate by the quoted hours.
Education Reimbursement The County will provide education reimbursement for education costs incurred by regular employees who apply for such reimbursement in accordance with the policies and procedures governing the education reimbursement program. The maximum reimbursement shall be $1,500 per year.
Project Management Services Contractor shall provide business analysis and project management services necessary to ensure technical projects successfully meet the objectives for which they were undertaken. Following are characteristics of this Service:
Lodging and Meal Expenses 1. Employees in travel status in the performance of their duties shall be entitled to expenses of necessary lodging and/or meals as provided for in Section 40 of the Manual of Financial Procedures, Travel and Expense Reimbursement Policy. Nothing contained in this Article shall be deemed to alter the present State policy prohibiting reimbursement for noon meals unless the meal is part of an organized meeting or program or overnight travel.
Payment Services 2.1 If the Payment Services is registered by the Application and the relevant Consents are submitted by the Customer, the Bank shall provide to the Customer the services (the “Payment Services”) of money transfer (“Money Transfer”) between the Accounts and other accounts as registered by the Customer.
