Claims Summary Report definition

Claims Summary Report. The MCO must submit quarterly, Claims Summary Reports to HHSC by MCO Program, by Service Area, and by claim type, by the 30th day following the reporting period unless otherwise specified. Measured Quarterly during the Operations Period Per calendar day of non-compliance, per MCO Program, per Service Area, per claim type. HHSC may assess up to $1,000 per calendar day the report is late, inaccurate, or incomplete.
Claims Summary Report. By referral source, unit number and grand total: number of npatient days and amount paid; number of physician service days and amount paid; and number of CD9/ICD10 and CPT/HCPCS codes. (Monthly and Cumulative Year-to-Date) 25 applicable; amount billed, paid, and disallowed; ICD9/ICD10 and CPT/HCPCS codes; description of 28 i

Examples of Claims Summary Report in a sentence

  • The format for the Claims Summary Report is contained in Chapter 5, Section 5.6.1 of the Uniform Managed Care Manual.

  • Also amended the provisions regarding Claims Processing Requirements and the Reporting Requirements for the Claims Summary Report.

  • These standards are intended solely for the guidance of prosecutors in the state of Washington.

  • HMO must submit the "All Claims Summary Report" identified in the Texas Managed Care Claims Manual as a contract year-to-date report.

  • The acknowledgment will consist of a Claims Submission Summary Report and the Error Claims Summary Report.

  • The format for the Claims Summary Report is contained in Uniform Managed Care Manual Chapter 5.6.1.

  • The Health Plan shall file an Aging Claims Summary Report quarterly, noting paid, denied and unpaid claims by provider type.

  • Claims Summary Report - The HMO must submit quarterly Claims Summary Reports to HHSC by HMO Program, Service Area and claim type by the 30th day following the end of the reporting period unless otherwise specified.

  • Department Heads are required to examine the Claims Summary Report and review their risk management.

  • Claims Inventory Summary Report The Health Plan shall file an Aging Claims Summary Report quarterly, noting paid, denied and unpaid claims by provider type.

Related to Claims Summary Report

  • ORSA summary report means a confidential high-level summary of an insurer or insurance group's own risk and solvency assessment.

  • Summary report means the year end report containing the summary of a

  • GLJ Report means the independent engineering reserves evaluation of certain oil, NGL and natural gas interests of the Company prepared by GLJ dated February 11, 2022 and effective December 31, 2021.

  • ESDM Report means the Emission Summary and Dispersion Modelling Report, dated June 12, 2009, prepared in accordance with the Procedure Document by Golder Associated Ltd. and submitted in support of the application, and includes any amendments to the ESDM Report listed in Schedule A and all up-dated ESDM Reports prepared as required by the Documentation Requirements conditions of this Certificate.

  • MI Report means a report containing Management Information submitted to the Authority in accordance with Framework Schedule 8 (Management Information);

  • Settlement Report a report summarizing Revolver Loans and participations in LC Obligations outstanding as of a given settlement date, allocated to Lenders on a Pro Rata basis in accordance with their Revolver Commitments.

  • Acoustic Assessment Report means the report, prepared in accordance with Publication NPC-233 and Appendix A of the Basic Comprehensive User Guide,by HGC Engineering and dated August 22, 2008 submitted in support of the application, that documents all sources of noise emissions and Noise Control Measures present at the Facility and includes all up-dated Acoustic Assessment Reports as required by the Documentation Requirements conditions of this Certificate to demonstrate continued compliance with the Performance Limits following the implementation of any Modification.

  • Survey Report means a report of the results of a Survey, containing the information set out in clause 12.4 and Schedule 6.

  • Progress Report means the report similar in form and content to that attached hereto as Appendix III.

  • Project Report means a summary statement of the likely environmental effects of a proposed development referred to in section 58;

  • Preliminary Report means the communication used for the prompt dissemination of data obtained during the early stages of the investigation;

  • Assessment Report : means the assessment report referred to in Articles 32(2) and 33(3) of Regulation (EC) No 834/2007 drawn up by an independent third party fulfilling the requirements of ISO Standard 17011 or by a relevant competent authority, which includes information on document reviews, including the descriptions referred to in Articles 4(3)(b) and 11(3)(b) of this Regulation, on office audits, including critical locations and on risk-oriented witness audits conducted in representative third countries.

  • insider report means a statement required to be filed pursuant to Section 16 of the Exchange Act (or any successor provisions), by a person who is a director of the Corporation or who is directly or indirectly the beneficial owner of more than ten percent of the shares of the Corporation.

  • Benchmarking Report means the report produced by the Supplier following the Benchmark Review and as further described in this Framework Schedule 7;

  • Case Report Form means a printed, optical or electronic document or database designed to record all of the information, which is required by the Protocol to be reported to the Sponsor on each Study Participant.

  • SOS Reports means the official reports from the Secretaries of State of each Collateral State, the state where Borrower’s chief executive office is located, the state of Borrower’s formation and other applicable federal, state or local government offices identifying all current security interests filed in the Collateral and Liens of record as of the date of such report.

  • Pick Up Report means the report detailing the number of sleeping rooms per day actually used out of the Program’s room block.

  • Project Management Report means each report prepared in accordance with Section 4.02 of this Agreement;

  • Detailed Project Report or ‘‘DPR’’ means the detailed project report relating to Station Development Project and Redevelopment Project attached hereto;

  • City Ledger Report means a list submitted by the Contractor indicating on a daily basis its total number of sleeping room nights rented as well as the total number for sleeping rooms removed from its available inventory or rentals, for purposes of repair.

  • Physical Conditions Report means, with respect to the Property, a report prepared by a company satisfactory to Lender regarding the physical condition of the Property, satisfactory in form and substance to Lender in its sole discretion, which report shall, among other things, (a) confirm that the Property and its use complies, in all material respects, with all applicable Legal Requirements (including, without limitation, zoning, subdivision and building laws) and (b) include a copy of a final certificate of occupancy with respect to all Improvements on the Property.

  • Condition Report means a condition report with respect to a Group III Vehicle, signed and dated by a Lessee or a Franchisee and any Manufacturer or its agent in accordance with the applicable Vehicle Disposition Program.