Balance Xxxx definition

Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay.
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Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. 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.
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Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Behavioral Management Services means structured services designed to serve individuals with emotional, behavioral, and neurobiological or substance use problems of such severity that appropriate functioning in the home, school, or community requires highly structured behavioral intervention. Benefit Issuance Date means the monthly date that the eREP system determines eligibility and the Medicaid Managed Care System (MMCS) issues premiums to Health Plans.
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Examples of Balance Xxxx in a sentence

  • Claims eligible for payment from the Provider Prove-Up Funds are Partially Allowed Claims from June 3, 2003 to the Preliminary Approval Date, provided that the Provider Class Member had an executed Assignment for such Partially Allowed Claims and (ii) the Provider Class Member presented or sent to the Plan Member a Balance Xxxx, and received no payment, or less than full payment, for the Balance Xxxx.

  • For Partially Allowed Claims that were reimbursed by the Company from March 1, 2001 to August 19, 2011, the Settlement Administrator will pay an amount equal to the lesser of (i) the Balance Xxxx paid by the Subscriber Class Member for that Covered Service or Supply or (ii) 5% of the Allowed Amount for that Partially Allowed Claim.

  • In any event, the Member is responsible for any applicable Deductible, Copayment or Coinsurance amounts stated in the Schedule of Benefits and, unless the fee is negotiated, for any Balance Xxxx from a Non-Preferred Provider who is not a Hospital-Based Physician, an On-Call Physician, or an Ambulance Service Provider who accepts an Assignment of Benefits.

  • Subscriber Class Members who assigned a claim for Covered Services or Supplies or did not pay a Balance Xxxx are not eligible for the Subscriber Prove-Up Fund.

  • Up Fund Claims eligible for payment from the Subscriber Prove-Up Fund are Partially Allowed Claims for which the Subscriber Class Member received and paid a Balance Xxxx from March 1, 2001 to the Preliminary Approval Date, provided that (i) the Subscriber Class Member did not execute an Assignment of such claim(s) and (ii) the total Balance Bills the Subscriber Class Member actually paid for Covered Services or Supplies are equal to or exceed $200.

  • For Partially Allowed Claims that were reimbursed by the Company from August 20, 2011 to the Preliminary Approval Date, the Settlement Administrator will pay an amount equal to the lesser of (i) the Balance Xxxx paid by the Subscriber Class Member or (ii) 3% of the Allowed Amount for that Partially Allowed Claim.

  • For Partially Allowed Claims that were reimbursed by the Company from August 20, 2011 to the Preliminary Approval Date, the Settlement Administrator will pay an amount equal to the lesser of (i) the Balance Xxxx outstanding for that Covered Service or Supply or (ii) 3% of the Allowed Amount for that Partially Allowed Claim.

  • A gentle swab of the sample surface with a kimwipe paper resulted in easy removal of the deposits in all the borided samples as indicated in Figure 3.

  • In addition, any Provider Class Member who does not Opt-Out of this Agreement and submits a claim to the Provider Prove-Up Fund, agrees not to Balance Xxxx any Plan Member at any point for any such claim deemed eligible by the Settlement Administrator.

  • Th e current Daily Periodic Rate for Purchases and Balance Xxxx sfers is .0431% The Daily Periodic Rate and the corresponding ANNUAL PERCENTAGE RATE may change (by increasing or decreasing) on the first day of each of your billing cycles that begin in March , Ju n e , September, and December.


More Definitions of Balance Xxxx

Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Behavioral Management Services means structured services designed to serve individuals with emotional, behavioral, and neurobiological or substance abuse problems of such severity that appropriate functioning in the home, school, or community requires highly structured behavioral intervention. BMHC means the Bureau of Managed Health Care, Division of Medicaid and Health Financing, Utah Department of Health. 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.
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Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Behavioral Management Services means structured services designed to serve individuals with emotional, behavioral, and neurobiological or substance use problems of such severity that appropriate functioning in the home, school, or community requires highly structured behavioral intervention. Benefit Issuance Date means the monthly date that the eREP system determines eligibility and the Medicaid Managed Care System (MMCS) issues premiums to Integrated Care Plans. Bureau of Managed Health Care (BMHC) means the entity within the Division of Medicaid and Health Financing, Utah Department of Health. 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.
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Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Behavioral Management Services means structured services designed to serve individuals with emotional, behavioral, and neurobiological or substance use problems of such severity that appropriate functioning in the home, school, or community requires highly structured behavioral intervention. Benefit Issuance Date means the monthly date that the eREP system determines eligibility and the Medicaid Managed Care System (MMCS) issues premiums to Health Plans. Bureau of Managed Health Care (BMHC) means the entity within the Division of Medicaid and Health Financing, Utah Department of Health. 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, except for the Delivery Case Rate. Capitation Payment means the payment the Department makes periodically to the Contractor on behalf of each Enrollee for the provision of Covered Services under the Contract and based on the actuarially sound Capitation Rate. The Department makes the payment regardless of whether the particular Enrollee receives services during the period covered by the payment. Capitation Rate means the rate negotiated between the Contractor and Department for each Medicaid eligibility group or Capitation Rate Cell. In developing actuarially sound Capitation Rates, the Department will apply the elements required in 42 CFR 438.6(c). Centers for Medicare and Medicaid Services (CMS) means the federal agency within the Department of Health and Human Services that administers the Medicare and Medicaid programs, and works with states to administer the Medicaid program. CHEC or Child Health Evaluation and Care means Utah’s former version of the federally mandated Early Periodic Screening, Diagnosis and Treatment (EPSDT) program as defined in 42 CFR Part 441, Subpart B. The program is now referred to as EPSDT. Child with Special Health Care Needs means a child under 21 years of age who has or is at increased risk for chronic physical, developmental, behavioral, or emotional conditions and requires health and related services of a type or amount beyond that required by children generally, including a child who, consistent with Section 1932(a)(2)(A) of the Social Security Act, 42 U.S.C.1396u-2(a)(2)(A):
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Balance Xxxx means a written xxxx, invoice, or other demand for payment from a provider or provider’s representative seeking payment from a Plan Member for the difference between a provider’s billed charge and the Company’s Allowed Amount for a Covered Service or Supply. A Balance Xxxx does not include a xxxx for any other amounts, such as Denied Claims, co-insurance, deductibles, and coordination of benefits. Under this Agreement, a Balance Xxxx includes any written xxxx for this amount regardless of when or how it is presented to the Plan Member, including a xxxx for the entire billed charge that the provider presented to the Plan Member in person at the time of the Covered Service or Supply, as well as a xxxx that the provider sent to the Plan Member by mail or other means after reimbursement of the Allowed Amount for the Covered Service or Supply by Company.
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Balance Xxxx as used in this Claim Form means, as defined in the Settlement, a written xxxx, invoice, or other demand for payment from a provider or provider’s representative seeking payment from a Plan Member for the difference between a provider’s billed charge and the Company’s Allowed Amount for a Covered Service or Supply. A Balance Xxxx does not include a xxxx for any other amounts, such as Denied Claims, co-insurance, deductibles, and coordination of benefits. Under this Agreement, a Balance Xxxx includes any written xxxx for this amount regardless of when or how it is presented to the Plan Member, including a xxxx for the entire billed charge that the provider presented to the Plan Member in person at the time of the Covered Service or Supply, as well as a xxxx that the provider sent to the Plan Member by mail or other means after reimbursement of the Allowed Amount for the Covered Service or Supply by Company. EXHIBIT B Must be Postmarked On or Before Xxxxxxxxx xx, 201x In re Aetna UCR Litigation Master Docket No. 07-3541(SRC)(PS)) U.S. District Court for the District of New Jersey For Official Use Only PROVIDER CLAIM FORM You should read the Notice of Proposed Settlement of Class Action and Final Settlement Hearing before completing this form. If you wish to submit a claim as a Provider Class Member under the Settlement, complete this form and mail it to the address below. Make sure to complete all required sections and sign the end of the claim form. For more information about this Settlement, please consult the Settlement Agreement and/or Settlement Notice (both of which are available in the Court’s file or at www. .com).
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Balance Xxxx as used in this Claim Form means, as defined in the Settlement, a written xxxx, invoice, or other demand for payment from a Provider or Provider’s representative seeking payment from a Plan Member for the difference between a Provider’s billed charge and the Company’s Allowed Amount for a Covered Service or Supply. A Balance Xxxx does not include a xxxx for any other amounts, such as Denied Claims, co-insurance, deductibles, and coordination of benefits. A Balance Xxxx includes any written xxxx for this amount regardless of when or how it is presented to the Plan Member, including a xxxx for the entire billed charge that the provider presented to the Plan Member in person at the time of the Covered Service or Supply, as well as a xxxx that the Provider sent to the Plan Member by mail or other means after reimbursement of the Allowed Amount for the Covered Service or Supply by Company.
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Related to Balance Xxxx

  • Balance Amount shall have the meaning set forth in Section 8.1 of this Agreement.

  • Original Benchmark Rate on any day means the 3-months Euro Interbank Offered Rate (expressed as a percentage rate per annum) fixed at, and appearing on, the Screen Page as of 11:00 a.m. (Brussels time) on such day.

  • Balance Due Date means the date shown below in Section 2.4(6) as the date when the Mortgage matures. On this date the Mortgage must be repaid or renewed.

  • PRE-2017 NET OPERATING LOSS CARRYFORWARD means any net operating loss incurred in a taxable year beginning before January 1, 2017, to the extent such loss was permitted, by a resolution or ordinance of the Municipality that was adopted by the Municipality before January 1, 2016, to be carried forward and utilized to offset income or net profit generated in such Municipality in future taxable years.(B) For the purpose of calculating municipal taxable income, any pre-2017 net operating loss carryforward may be carried forward to any taxable year, including taxable years beginning in 2017 or thereafter, for the number of taxable years provided in the resolution or ordinance or until fully utilized, whichever is earlier.

  • Unpaid Realized Loss Amount With respect to any Class A Certificates and as to any Distribution Date, is the excess of Applied Realized Loss Amounts with respect to such Class over the sum of all distributions in reduction of the Applied Realized Loss Amounts on all previous Distribution Dates. Any amounts distributed to the Class A Certificates in respect of any Unpaid Realized Loss Amount shall not be applied to reduce the Certificate Principal Balance of such Class.

  • Balance means the total financial result in the Client Account after the last Completed Transaction and depositing/withdrawal operation at any period of time.

  • SF1-4 Intrinsic Loss Estimate means total losses under this Single Family Shared-Loss Agreement in the amount of eighteen million dollars ($18,000,000.00).

  • 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.

  • Allocated Realized Loss Amount With respect to any Distribution Date and any Class of Mezzanine Certificates, the sum of (i) any Realized Losses allocated to such Class of Certificates on such Distribution Date and (ii) the amount of any Allocated Realized Loss Amount for such Class of Certificates remaining unpaid from the previous Distribution Date.

  • 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.

  • Balance Date means 30 June or any other date that the Trustees by resolution adopt as the date up to which the Trust’s financial statements are to be made in each year;

  • Monthly Loss Amount means the sum of all Foreclosure Losses, Restructuring Losses, Short Sale Losses, Portfolio Losses, Modification Default Losses and Deficient Losses realized by the Assuming Institution for any Shared Loss Month.

  • Liquidation Loss Amount With respect to any Payment Date and any Mortgage Loan that became a Liquidated Mortgage Loan during the related Collection Period, the unrecovered portion of the Principal Balance of such Mortgage Loan and any unpaid accrued interest thereon at the end of such Collection Period, after giving effect to the Net Liquidation Proceeds applied in reduction of such Principal Balance.

  • Class C Unpaid Realized Loss Amount As of any Distribution Date, the excess of (1) the Class C Applied Realized Loss Amount over (2) the sum of (x) all distributions in reduction of the Class C Unpaid Realized Loss Amounts on all previous Distribution Dates and (y) all increases in the Certificate Principal Balance of such Class C Certificates pursuant to the last sentence of the definition of "Certificate Principal Balance."

  • Monthly Shared-Loss Amount means the change in the Cumulative Shared- Loss Amount from the beginning of each month to the end of each month.

  • Shared-Loss Amount has the meaning provided in Section 2.1(b)(i) of this Commercial Shared-Loss Agreement.

  • Net Loss Amount means the sum of Cumulative Loss Amounts under this Single Family Shared-Loss Agreement and Aggregate Net Charge-Offs under the Commercial Shared-Loss Agreement.

  • Fraud Loss Amount As of any date of determination after the Cut-off Date, an amount equal to: (X) prior to the first anniversary of the Cut-off Date an amount equal to 3.00% of the aggregate outstanding principal balance of all of the Mortgage Loans as of the Cut-off Date minus the aggregate amount of Fraud Losses allocated solely to one or more specific Classes of Certificates in accordance with Section 4.05 of this Series Supplement since the Cut-off Date up to such date of determination, (Y) from the first to, but not including, the second anniversary of the Cut-off Date, an amount equal to (1) the lesser of (a) the Fraud Loss Amount as of the most recent anniversary of the Cut-off Date and (b) 2.00% of the aggregate outstanding principal balance of all of the Mortgage Loans as of the most recent anniversary of the Cut-off Date minus (2) the aggregate amount of Fraud Losses allocated solely to one or more specific Classes of Certificates in accordance with Section 4.05 since the most recent anniversary of the Cut-off Date up to such date of determination, and (Z) from the second to, but not including, the fifth anniversary of the Cut-off Date, an amount equal to (1) the lesser of (a) the Fraud Loss Amount as of the most recent anniversary of the Cut-off Date and (b) 1.00% of the aggregate outstanding principal balance of all of the Mortgage Loans as of the most recent anniversary of the Cut-off Date minus (2) the aggregate amount of Fraud Losses allocated solely to one or more specific Classes of Certificates in accordance with Section 4.05 since the most recent anniversary of the Cut-off Date up to such date of determination. On and after the fifth anniversary of the Cut-off Date, the Fraud Loss Amount shall be zero. The Fraud Loss Amount may be further reduced by the Master Servicer (including accelerating the manner in which such coverage is reduced) provided that prior to any such reduction, the Master Servicer shall (i) obtain written confirmation from each Rating Agency that such reduction shall not reduce the rating assigned to any Class of Certificates by such Rating Agency below the lower of the then-current rating or the rating assigned to such Certificates as of the Closing Date by such Rating Agency and (ii) provide a copy of such written confirmation to the Trustee.

  • Loss Amount means the dollar amount of loss incurred and reported on the Monthly Certificate for a Single Family Shared-Loss Loan.

  • Cumulative Loss Amount means the sum of the Monthly Loss Amounts less the sum of all Recovery Amounts.

  • Total Intrinsic Loss Estimate means the sum of the SF1-4 Intrinsic Loss Estimate in the Single Family Shared-Loss Agreement, and the Commercial Intrinsic Loss Estimate in the Commercial Shared-Loss Agreement, expressed in dollars.

  • Principal Loss Amount With respect to each Payment Date, the sum of: (a) the aggregate amount of Credit Event Net Losses for all Credit Event Reference Obligations for the related Reporting Period; (b) the aggregate amount of court-approved principal reductions (“cramdowns”) on the Reference Obligations in the related Reporting Period; (c) subsequent losses on any Reference Obligation that became a Credit Event Reference Obligation on a prior Payment Date; and (d) amounts included in the second, fourth, seventh, eighth and tenth priorities set forth in Section 3.03(f) hereof.

  • Balance Computation Method We use the daily balance method to calculate the interest on your account. This method applies a daily periodic rate to the balance in the account each day. Compounding and Crediting: Interest is compounded daily and calculated on a 365/366 day basis. Interest is credited on a monthly basis.

  • REMIC 2 Interest Loss Allocation Amount With respect to any Distribution Date, an amount equal to (a) the product of (i) the aggregate Stated Principal Balance of the Mortgage Loans and related REO Properties then outstanding and (ii) the Uncertificated REMIC 2 Pass-Through Rate for REMIC 2 Regular Interest LTAA minus the Marker Rate, divided by (b) 12.

  • Planned Balance With respect to any group of Planned Principal Classes or Components in the aggregate and any Distribution Date appearing in Schedule V hereto, the Aggregate Planned Balance for such group and Distribution Date. With respect to any other Planned Principal Class or Component and any Distribution Date appearing in Schedule V hereto, the applicable amount appearing opposite such Distribution Date for such Class or Component.

  • Applied Loss Amount With respect to any Distribution Date, the amount, if any, by which (x) the aggregate Certificate Principal Amount of the Certificates after giving effect to all Realized Losses incurred with respect to the Mortgage Loans during the related Collection Period and distributions of principal on such Distribution Date, but before giving effect to any application of the Applied Loss Amount with respect to such date, exceeds (y) the Pool Balance for such Distribution Date.