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

  • Case rate methodology is an all-inclusive rate for an episode of care for a specific clinical condition paid to a facility.

  • Case rate payments are adjusted based on the service utilization provided during the lookback period per Table 1.

  • Therefore, the Commission, by ruling in the 2010 Rate Case that BHIT’s identified assets were “used and useful,” the Commission was not declaring that the Parking Facilities were not “used and useful” in provide ferry service.14But even if the Commission had addressed the issue at hand in the 2010 Rate Case, rate cases rulings are legislative, not judicial, in nature and, for that reason, such rulings are not binding in later proceedings.

  • In addition, the Contractor may Invoice the Agency in the month following the month of service on Cases exceeding 60 at a Case rate of $475.00 per Case for each additional case up to a maximum of 100 Cases.


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 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 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 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 method of payment for delivery of Services by the Contractor, determined by the formula set out by the EACFS.
Case rate means the all-inclusive Anthem Rate for an entire admission or one outpatient encounter for Covered Services. "Coded Service Identifier(s)" means a listing of descriptive terms and identifying codes, updated from time to time by CMS or other industry source, for reporting Health Services on the CMS 1500 claim form or its successor as applicable based on the services provided. The codes include but are not limited to, American Medical Association Current Procedural Terminology ("CPT®-4"), CMS Healthcare Common Procedure Coding System ("HCPCS"), International Classification of Diseases, 10th Revision ("ICD-10"), National Uniform Billing Committee ("Revenue Code") and National Drug Code ("NDC") or their successors.
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 --------------------------------------------------------------------------------