Quality improvement organization or “QIO” shall mean the organization that performs medical peer review of Medicaid claims, including review of validity of hospital diagnosis and procedure coding information; completeness, adequacy and quality of care; appropriateness of admission, discharge and transfer; and appropriateness of prospective payment outlier cases. These activities undertaken by the QIO may be included in a contractual relationship with the Iowa Medicaid enterprise.
Service Provider Number Portability (SPNP) is synonymous with Permanent Number Portability “PNP”.
Police Force means the Mauritius Police Force and includes any other police force established in accordance with such provision as may be prescribed by Parliament;
Medical Specialist means any medical practitioner who is vocationally registered by the Medical Council under the Health Practitioners Competence Assurance Act 2003 in one of the approved branches of medicine and who is employed in either that branch of medicine or in a similar capacity with minimal oversight.
Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be: