Cost outlier definition

Cost outlier means cases which have an extraordinarily high cost as established in 79.1(5)“f,” so as to be eligible for additional payments above and beyond the initial DRG payment.
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Cost outlier means services provided during a single visit that have an extraordinarily high cost as established in paragraph “g” and are therefore eligible for additional payments above and beyond the base APC payment.
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Cost outlier means cases which have an extraordinarily high cost as established in paragraph
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Examples of Cost outlier in a sentence

  • Cost outlier payments are not available for cases reimbursed using the level-of-care methodology except for burn cases that exceed the established threshold.

  • Cost outlier payments shall be paid on short stay outlier cases that qualify as a cost outlier.

  • Cost outlier cases are determined according to a threshold established by the office.

  • Cost outlier status does not depend on length of stay as such, but in practice cost outlier stays tend to be long stays—hence the requirement for concurrent review on stays that exceed 19 days.

  • Cost outlier payments may be subject to adjustment in cases of suspected fraud and/or abuse.

  • Cost outlier payments are an additional payment made at the time a claim is processed for exceptionally costly services.

  • For post acute care special pay transfer DRGs Cost outlier payment + the minimum of: a.

  • Cost outlier payments will be made to stays that qualify as a cost outlier stay, which will be determined by comparing the hospital’s estimated loss on a particular stay with the cost outlier threshold amount.

  • Corporate Member intending to send their authorized representatives to attend the Meeting pursuant to Section 113 of the Companies Act, 2013 are requested to send a certified copy of the relevant Board Resolution together with specimen signatures of those representative(s) authorized under the said resolution to attend and vote on their behalf at the Meeting.

  • Cost outlier payments are an additional payment made to in-state and contiguous hospitals for exceptionally costly services or exceptionally long lengths of stay provided to Title XIX and SF (State Facility) clients.


More Definitions of Cost outlier

Cost outlier means cases which have an extraordinarily high cost as established in 79.1(5)“f,” so as to be eligible for additional payments above and beyond the initial DRG payment. “Critical access hospital” or “CAH” means a hospital licensed as a critical access hospital by the
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Cost outlier means cases which have an extraordinarily high cost as established in 79.1(5)“f,” so as to be eligible for additional payments above and beyond the initial DRG payment. “Diagnosis-related group (DRG)” shall mean a group of similar diagnoses combined based on pa-
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Cost outlier means cases which services provided during a single visit that have an extraordinarily high cost as established in paragraph “g” and, thus, are therefore eligible for additional payments above and beyond the base APG APC payment.
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Cost outlier means an additional payment for unusually high cost cases that exceeds the cost outlier thresholds as set forth in ARM 37.86.2916.
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Related to Cost outlier

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  • Project Costs means all allowable costs, as set forth in the applicable Federal cost principles, incurred by a recipient and the value of the contribu- tions made by third parties in accom- plishing the objectives of the award during the project period.