Managed Care Technical Manual definition

Managed Care Technical Manual or “MCTM” A document developed by the Department that provides the technical specifications for the submission of encounters and other contract deliverables, including monthly, quarterly, annual, and other required reports from MCOs. In addition, it supplies technical information on enrollment and payment files, Department- generated files, and Departmental processes such as the processing of incarcerated members and the reconciliation of payments for newborn members.
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Examples of Managed Care Technical Manual in a sentence

  • The Contractor agrees to adhere to all additional reporting requirements related to the xxxxxx care and adoption assistance population, as outlined in the Managed Care Technical Manual.

  • The Contractor shall submit its policies and procedures in accordance with the Managed Care Technical Manual.

  • This Contract includes the program requirements and specifications as outlined in RFP 2017-03, this Contract, and the Managed Care Technical Manual.

Related to Managed Care Technical Manual

  • Project Manual means the volume usually assembled for the Work which may include the bidding requirements, sample forms, and other Contract Documents.

  • Program Manual means the United States Department of Agriculture, Animal and Plant Health Inspection Service, Plant Protection and Quarantine, Gypsy Moth Program Manual, 1994 edition.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Managed care means a system that provides the coordinated delivery of services and supports that are necessary and appropriate, delivered in the least restrictive settings and in the least intrusive manner. Managed care seeks to balance three factors:

  • Technical data means recorded information, regardless of the form or method of the recording, of a scientific or technical nature (including computer software documentation). The term does not include computer software or data incidental to contract administration, such as financial and/or management information.

  • User Manual means the user guide, Help Guide, documentation provided with the Software, updated agreements provided on the website of Quick Heal (xxx.xxxxxxxxx.xxx), explanatory or other materials as provided from time to time by Quick Heal.

  • technical specification means, with respect to any Software, the document setting forth the technical specifications for such Software and included in the Statement of Work.

  • Technical Specifications means the detailed requirements for the Work furnished by the Architect and set forth in Book 3 of the Contract Documents.

  • Technical safeguards means the technology and the policy and procedures for its use that 27 protect electronic PHI and control access to it.

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • MSAA Indicator Technical Specifications document means, as the context requires, either or both of the document entitled “Multi-Sector Service Accountability Agreement (MSAA) 2019-20 Indicator Technical Specifications November 5, 2018 Version 1.3” and the document entitled “Multi-Sector Service Accountability Agreement (MSAA) 2019-20 Target and Corridor-Setting Guidelines” as they may be amended or replaced from time to time;

  • Web Site Accessibility Standards/Specifications means standards contained in Title 1 Texas Administrative Code Chapter 206.

  • Pharmacy technician or “technician” means a person who is employed in Iowa by a licensed pharmacy under the responsibility of an Iowa-licensed pharmacist to assist in the technical functions of the practice of pharmacy, and who is registered pursuant to 657—Chapter 3, and includes a certified pharmacy technician, a pharmacy technician trainee, and an uncertified pharmacy technician.

  • Clinical nurse specialist means a registered nurse with relevant post-basic qualifications and 12 months’ experience working in the clinical area of his/her specified post-basic qualification, or a minimum of four years’ post-basic registration experience, including three years’ experience in the relevant specialist field and who satisfies the local criteria.

  • Design Manual means the MOHLTC design manual or manuals in effect and applicable to the development, upgrade, retrofit, renovation or redevelopment of the Home or Beds subject to this Agreement.

  • Project Implementation Manual or “PIM” means the manual setting out the measures required for the implementation of the Project, as the same may be amended from time to time, subject to prior approval of the Association;

  • Program Materials means the documents and information provided by the Program Administrator specifying the qualifying EEMs, technology requirements, costs and other Program requirements, which include, without limitation, program guidelines and requirements, application forms and approval letters.

  • Clinical Data means the information concerning the safety or performance that is generated from the use of a device and that are sourced from the following: