MSN Enrollee definition

MSN Enrollee or “Enrollee” means a person, enrolled in the MSN Program, meeting the 12 eligibility criteria set by ADMINISTRATOR in order to meet its obligations under W&I 17000.
Sample 1Sample 2Sample 3

Examples of MSN Enrollee in a sentence

  • If CONTRACTOR has an MSN Enrollee, who is Medically Stable as defined under 33 EMTALA, that requires Special Permit Medical Services, CONTRACTOR shall contact the CCU to 34 request the transfer of said MSN Enrollee to, at the discretion of ADMINISTRATOR, a Contracting 35 Hospital or other facility capable of providing said services.

  • Real Estate Agent Ryan Snow, of NAI BT Commercial Real Estate, provided a lease analysis which projects the property could achieve net rents of approximately $110,000 to $147,000 per year or $10,000 to $12,000 a month.

  • In order for any Hospital Claims to be considered for any Final Settlement adjustment as 17 provided herein, CONTRACTOR must submit all Claims to Intermediary, whether or not due to 18 CONTRACTOR’s collection of the co-payment from the MSN Enrollee, the Claims are eligible for the 19 Interim Payment, as specified in Paragraph VI of this Exhibit B to the Agreement.

  • If CONTRACTOR has an MSN Enrollee, who is Medically Stable as defined under 7 EMTALA, that requires Special Permit Medical Services, CONTRACTOR shall contact the CCU to 8 request the transfer of said MSN Enrollee to, at the discretion of ADMINISTRATOR, a Contracting 9 Hospital or other facility capable of providing said services.

  • Saunders is among the almost 2,000 missing and murdered Indigenous women, girls, and two-spirit people in Canada (NATIONAL INQUIRY, 2019), a subject she herself was researching.

  • If CONTRACTOR has an MSN Enrollee, who is Medically Stable as defined under 21 EMTALA, that requires Special Permit Medical Services, CONTRACTOR shall contact the CCU to 22 request the transfer of said MSN Enrollee to, at the discretion of ADMINISTRATOR, a Contracting 23 Hospital or other facility capable of providing said services.

  • Acceptance by All Providers of payments made by CONTRACTOR in accordance with the 30 Agreement shall be deemed satisfaction in full of any obligation to All Providers, and no Provider shall 31 seek additional reimbursement from an MSN Enrollee, with respect to those claims for Medical Services 32 for which payment has been made by the MSN Program, notwithstanding a Provider’s right to appeal 33 any denied claim, as provided for in subparagraph VI.

Related to MSN Enrollee

  • Enrollee means any person entitled to health care services from a carrier.

  • Potential Enrollee means a Medical Assistance Recipient who may voluntarily elect to enroll in a given managed care program, but is not yet an Enrollee of an MCO.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with or employed by the health carrier.

  • Late enrollee means an eligible employee or dependent who

  • Family child care provider means a person who: (a) Provides

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • Health plan or "health benefit plan" means any policy,

  • Newborn means a baby less than nine days old.

  • Radiologist assistant means an individual who has met the requirements of the Board for licensure

  • Medicare Provider Agreement means an agreement entered into between CMS (or other such entity administering the Medicare program on behalf of the CMS) and a health care provider or supplier, under which such health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Open enrollment means a period of time as defined in rule

  • Child care provider means a provider who receives compensation for providing child care services on a regular basis, including an ‘eligible child care provider’ (as defined in section 658P of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858n)).

  • Managed Care Organization (MCO) means a contracted health delivery system providing capitated or prepaid health services, also known as a Prepaid Health Plan (PHP). An MCO is responsible for providing, arranging, and making reimbursement arrangements for covered services as governed by state and federal law. An MCO may be a Chemical Dependency Organization (CDO), Dental Care Organization (DCO), Mental Health Organization (MHO), or Physician Care Organization (PCO).

  • Pharmacy benefits management means the administration or management of prescription drug

  • child care element of working tax credit means the element of working tax credit prescribed under section 12 of the Tax Credits Act 2002 (child care element).

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • CMS means the Centers for Medicare and Medicaid Services.

  • Audiologist means an individual who is licensed by a state to practice audiology.

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • Radiologist means a medical practitioner who specialises in the provision of radiological services within the meaning of the Health Insurance Act 1973.

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79

  • Provider Organization means a group practice, facility, or organization that is:

  • Non-Participating Certified Clinical Nurse Specialist means a Certified Clinical Nurse Specialist who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.

  • Provider Enrollment means an agreement between the Department and a Medicaid provider to provide room and board and deliver care and services to a Medicaid eligible individual in an adult foster home for compensation.

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.