Medicaid MCO will definition

Medicaid MCO will mean a managed care organization that has contracted with the Department to provide Medicaid benefits to Medicaid members.
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Examples of Medicaid MCO will in a sentence

  • At least one year in advance of an individual aging out of this program, the Interdisciplinary Team and Medicaid MCO will commence transition planning to identify service needs and necessary resources.

  • The payments to each Medicaid MCO will be based on data submitted by the MCO and will be required to be in compliance with 42 CFR 438.604 Data that must be Certified, and 42 CFR 438.606 Source, Content, Timing of Certification.

  • This means that the amount a Medicaid MCO will pay for an ED visit will generally be lower than the cost of the visit.

  • The Medicaid MCO will cover emergency room services for its enrollees except services provided to members with primary codes of 290 through 319.

  • Providers billing Medicaid-eligible services to a Medicaid MCO will receive payment for those services directly through the Medicaid MCO contract.

  • Medicaid MCO will be reported separately in the Insurer Level category; however, Medicaid FFS will not.

  • Mohammed ENNAHBAOUI and Said EL HAJJI are members in Lab- oratory of Mathematics, Computing and Applications (LabMIA), part of the Faculty of sciences in the University of Mohammed V-Agdal of Rabat- Morocco.

  • In response to a commenter’s concern that the requirements could affect Medicaid MCOs and their negotiations with states and manufacturers regarding VBP supplemental rebates, CMS agrees that the state and Medicaid MCO will need to establish responsibilities related to the collection and reporting of the required data elements.

  • Moving forward, this initiative will be referred to as the Texas Credentialing Alliance (TCA).Beginning in April 2018, all new and providers currently contracted with a Medicaid MCO will begin to receive notifications from Aperture regarding initial credentialing events and information about the common recredentialing date.

Related to Medicaid MCO will

  • Medicaid program means the medical assistance

  • Medicaid means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of Title XIX of the Social Security Act, codified at 42 U.S.C. 1396 et seq.

  • Medicare Advantage The Medicare managed care options that are authorized under Title XVIII as specified at Part C and 42 C.F.R. § 422.

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Medicare means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Medicare Select issuer means an issuer offering, or seeking to offer, a Medicare Select policy or certificate.

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Child welfare agency means a child-placing agency, child-caring institution or independent foster

  • Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.

  • Licensed health care professional means a person who possesses a professional medical license that is valid in Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner (NP), licensed practical nurse (LPN), medical doctor (MD), osteopathic physician (DO), respiratory therapist (RT), physical therapist (PT), physician assistant (PA), or occupational therapist (OT).

  • Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.

  • Health care service means that service offered or provided

  • Health care practitioner means an individual licensed