Amounts Billed definition

Amounts Billed means paid Claims in addition to the combined amount of BlueCard Fees and AAC, if any. AAC and/or BlueCard Fees shall only be included as “Amounts Billed” where such AAC or fees are paid in association with the types of Claims specified on the Exhibit and in settlement of Claims for any benefits under the Plan, and are:
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Amounts Billed means the amount that Group shall reimburse and pay BCBSM for Claims which have been processed and paid by BCBSM or another BCBS Plan under the terms of this Contract, Pharmacy Benefits if applicable, the Administrative Fee set forth in Schedule A, any Additional Administrative Compensation (“AAC”) as set forth in Schedule A, Michigan Claims Tax, Pharmacy benefit fees as set forth in Schedule A, Health Care Provider Interest, and other fees and charges as set forth in Schedules A and B.
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Amounts Billed means the amount that Group shall reimburse and pay BCBSM for Claims which have been processed and paid by BCBSM or another BCBS Plan under the terms of this Contract.
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Examples of Amounts Billed in a sentence

  • Amounts Billed during the current Policy Period (less Specific (Individual) Stop-Loss Claims, if any) that exceed the Attachment Point.

  • Run-Out Stop-Loss Insurance – The Amounts Billed during the Run-Out Period for Claims Incurred since the original Effective Date of Policy in excess of the Individual Attachment Point identified in B.3. above less any Specific (Individual) Stop-Loss Claims previously paid for Amounts Billed paid during the Run-Out Period.

  • Specific (Individual) Stop-Loss Coverage – The Amounts Billed during the current Policy Period in excess of the Individual Attachment Point in B.3. above per Policy Period.


More Definitions of Amounts Billed

Amounts Billed means the amount the State owes in accordance with BCBSM's standard operating procedures for payment of Enrollees' claims.
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Related to Amounts Billed

  • Amount Generally Billed or “AGB” means, with respect to emergency and other medically necessary care, the amount generally billed to individuals who have insurance covering such care.

  • Fixed Amounts has the meaning assigned to such term in Section 1.07(b).

  • 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.

  • Undisputed Amounts has the meaning set forth in Section 2.04(c)(iii).

  • Indirect Cost Rate means a device for determining in a reasonable manner the proportion of indirect costs each Program should bear. It is a ratio (expressed as a percentage) of the Indirect Costs to a Direct Cost base. If reimbursement of Indirect Costs is allowable under an Award, Grantor will not reimburse those Indirect Costs unless Grantee has established an Indirect Cost Rate covering the applicable activities and period of time, unless Indirect Costs are reimbursed at a fixed rate.

  • Overpayments as used in this Section include payments (i) made by the System Agency that exceed the maximum allowable rates; (ii) that are not allowed under applicable laws, rules, or regulations; or (iii) that are otherwise inconsistent with this Contract, including any unapproved expenditures. Xxxxxxx understands and agrees that it will be liable to the System Agency for any costs disallowed pursuant to financial and compliance audit(s) of funds received under this Contract. Xxxxxxx further understands and agrees that reimbursement of such disallowed costs shall be paid by Grantee from funds which were not provided or otherwise made available to Grantee under this Contract.

  • Service Charges means the fees levied by the municipality in terms of its tariff policy for any municipal services rendered in respect of an immovable property and includes any penalties, interest or surcharges levied or imposed in terms of this policy.

  • Avoidable Cost Rate means a component of the Market Seller Offer Cap calculated in accordance with Tariff, Attachment DD, section 6. Balancing Congestion Charges: “Balancing Congestion Charges” shall be equal to the sum of congestion charges collected from Market Participants that are purchasing energy in the Real-time Energy Market minus [the sum of congestion charges paid to Market Participants that are selling energy in the Real-time Energy Market plus any congestion charges calculated pursuant to the Joint Operating Agreement between the Midcontinent Independent Transmission System Operator, Inc. and PJM Interconnection, L.L.C. (PJM Rate Schedule FERC No. 38), plus any congestion charges calculated pursuant to the Joint Operating Agreement Among and Between New York Independent System Operator Inc. and PJM Interconnection, L.L.C. (PJM Rate Schedule FERC No. 45), plus any congestion charges calculated pursuant to agreements between the Office of the Interconnection and other entities, plus any charges or credits calculated pursuant to Operating Agreement, Schedule 1, section 3.8, and the parallel provisions of Tariff, Attachment K-Appendix, section 3.8, as applicable)].

  • Unallowable Costs has the same meaning as in 44 Ill. Admin. Code Part 7000.

  • Declined Amounts has the meaning specified in Section 2.05(c).

  • Usage Charges means the Charges for the Service or applicable part of the Service that are calculated by multiplying the volume of units that the Customer used or incurred in a period (e.g. number of users using the Service, or the number of minutes the Service was used for) with the relevant fee that is specified in the Online Order.

  • Deactivation Avoidable Cost Rate means the formula rate established pursuant to Tariff, section 115 of this Tariff.

  • Monthly Charges means a finance carrying charge of **** and a storage and handling charge of ****, in each case of the Cost of the Inventory and/or Special Inventory and/or of the fees for the Product affected by the reschedule or cancellation (as applicable) per month until such Inventory and/or Special Inventory and/or Product is returned to the vendor, used to manufacture Product or is otherwise purchased by Customer.

  • Support Cost Rate means the flat rate at which the Partner will be reimbursed by UN Women for its Support Costs, as set forth in the Partner Project Document and not exceeding a rate of 8% or the rate set forth in the Donor Specific Conditions, if that is lower. The flat rate is calculated on the eligible Direct Costs.

  • Routine patient care costs means Covered Medical Expenses which are typically provided absent a clinical trial and not otherwise excluded under the Policy. Routine patient care costs do not include:

  • Allowable Costs means the costs defined as allowable in 42 CFR, Chapter IV, Part 413, as amended to October 1, 2007, except for the purposes of calculating direct medical education costs, where only the reported costs of the interns and residents are allowed. Further, costs are allowable only to the extent that they relate to patient care; are reasonable, ordinary, and necessary; and are not in excess of what a prudent and cost-conscious buyer would pay for the given service or item.