Compensation basis definition
Examples of Compensation basis in a sentence
Except where RPO an behalf of RPO Providers is compensated on a Capitation Compensation basis, RPO may require RPO Providers to bill and accept compensation directly from Texas HealthSpr▇▇▇ or Payors, less Copayment amounts payable by Members in accordance with the applicable Benefit Program.
When RPO is compensated on a Capitation Compensation basis, Texas HealthSpring shall provide RPO with a monthly list of Members for whom RPO is responsible for rendering RPO Risk Services during such month.
When RPO on behalf of RPO Providers is compensated on a Capitation Compensation basis, RPO shall be entitled to conduct Coordination of Benefits.
When Provider is compensated on ------------------------------ a Capitation Compensation basis, Foundation shall provide Provider with a monthly list of Beneficiaries for whom Provider is responsible for rendering Provider Risk Services during such month.
Except when RPO on behalf of RPO Providers is compensated on a Capitation Compensation basis when a Member has coverage which is primary through another carrier, then Texas HealthSpring's or a Payor's compensation to RPO Provider shall be limited to the difference between the amount paid by the primary payor and the contract rates, including Copayments, contained in the applicable Addendum to this Agreement.
In the event Provider elects to purchase reinsurance from Foundation, and is capitated on a Capitation Compensation basis, Provider shall submit to Foundation clean, complete and accurate claims in a format approved by Foundation for Provider Risk Services in excess of the stop loss threshold.
When RPO on behalf of RPO Providers is compensated on a Capitation Compensation basis, RPO shall be entitled to conduct Third Party Recoveries.
When Provider is compensated on a Capitated Compensation basis, Provider shall be entitled to conduct Coordination of Benefits for those services where Provider is so paid.
When RPO on behalf of RPO Providers is not compensated on a Capitation Compensation basis, RPO Provider shall submit to Texas HealthSpring, via Texas HealthSpring's electronic claims submission program or hardcopy format, clean, complete and accurate claims in a format approved by Texas HealthSpring for Contracted Services rendered to a Member, within ninety (90) calendar days after such services are rendered.
In lieu of such arrangement, unless RPO is compensated an a Capitation Compensation basis, RPO shall bill and accept payment for Contracted Services rendered b▇ ▇▇O Providers, and be responsible for administering such funds and compensating RPO Providers therefrom.