Case rate definition
Case rate means the maximum premium rate or schedule of premium rates permitted to be charged with respect to the cov- erage of a creditor. Unless a higher premium rate or schedule of premium rates is approved by the commissioner, the case rate is the prima facie premium rate or schedule of premium rates.
Case rate means a method of payment based on diagnosis. Case
Case rate means a method of payment based on diagnosis. Case rate assumes that a given set of services shall be provided and the rate is based on the total compensation for those services.
Examples of Case rate in a sentence
DRG Case Rate for C-Section (783-788) $12,734 DRG Case Rate for NICU (789-794) $22,008 DRG Case Rate for Newborn (795) $2,221 DRG Case Rate for Vaginal Delivery (805-807) $7,405 DRG Carve Out Rate increase of 2% year 2 (eff.
More Definitions of Case rate
Case rate means a flat fee paid for newborn nurse home visiting services. The case rate includes all newborn nurse home visiting services, including Community Lead Service Requirements outlined in OAR 333-006-0050 and Newborn Nurse Home Visiting Provider and Service Requirements outlined in OAR 333-006-0100 through333-006-0130. The case rate is also known as a bundled claim.¶
Case rate means the sum of all allowed charges for Medically Necessary Services provided during or in relation to an Episode of Care (inclusive of all technical, professional, facility, and other medical services) billed by Providers. Covered Services included in a Case Rate commonly include, but are not limited to: (a) the Medically Necessary Services rendered by a Provider during an Episode of Care (b) equipment used by a hospital or facility; (c) in-hospital or in-facility medications or biologics and supplies; (d) implants; (e) laboratory testing and services; (f) in-hospital meals; (g) hospital confinement days; (h) in-hospital or in-facility nursing care; (i) in-hospital physical therapy; and (j) post-discharge follow-up consultations occurring within the applicable global period defined by the Centers for Medicare & Medicaid Services (“CMS”). Services commonly excluded from a Case Rate include, but are not limited to: (1) medical consultations and certain diagnostic testing provided in advance of a medical procedure to determine whether or not such procedure is a Medically Necessary Service; (2) Convenience Items; (3) Travel Services; and (4) any medical procedure or medical care that is not a Medically Necessary Service.
Case rate means the all inclusive Anthem Rate for an entire admission or one outpatient encounter. "Global Case Rate" means the all inclusive Anthem Rate which includes facility, professional and physician services for specific Coded Service Identifier(s).
Case rate means the amount to be multiplied by capacity to determine monthly payments to the Contractor from the RBHA.
Case rate means the amount to be multiplied by capacity to determine monthly payments to the Contractor from the RBHA. -------------------------------------------------------------------------------- [LOGO] Community Partnership FEE FOR SERVICE and RISK-BASED of Southern Arizona SUBCONTRACT AGREEMENT Regional Behavioral CHILDREN SERVICES Health Authority The Providence Service Corporation ------------------------------------------------- CONTRACT NUMBER: A0108 FY 01/02 --------------------------------------------------------------------------------
Case rate means a flat rate paid per Member for a specific range of services. A Case Rate may be paid for each referral made to a Provider or for each admission made to a hospital. The Provider receiving the payment assumes the risk of providing all Covered Services for the full range of services for each Member for whom the payment was made.
Case rate means a flat rate paid per OHP Member for a specific range of services. A Case Rate may be paid for each referral made to a Provider or for each admission made to a hospital. The Provider receiving the payment assumes the risk of providing all Covered Services for the full range of services for each OHP Member for whom the payment was made.