No Credibility definition

No Credibility means the experience of a CCO is determined, under CMS guidance4, to be insufficient, measured in terms of member months, for the reliable calculation of a MLR. A CCO that is assigned No Credibility (or is Non-credible) will not be measured against any MLR requirements.
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No Credibility. As defined in 42 CFR § 438.8, a standard for which the experience of an MCO is determined to be insufficient for the calculation of a Medical Loss Ratio (MLR). An MCO that is assigned no credibility (or is non-credible) will not be measured against any MLR requirements.
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No Credibility means a standard for which the experience of a PAHP is determined to be insufficient for the calculation of a MLR. A PAHP that is assigned no credibility (or is non-credible) will not be measured against any MLR requirements.
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Examples of No Credibility in a sentence

  • A Contractor that is assigned No Credibility (or is Non-Credible) will not be measured against any MLR requirements.


More Definitions of No Credibility

No Credibility means a standard for which the experience of an MCO is determined to be insufficient for the calculation of an MLR.
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Related to No Credibility

  • Integrity means probity, fairness, honesty, uprightness, and soundness of character.

  • Success means that the Client’s claim is finally decided in his or her favour, whether by a court decision or an agreement to pay damages or in any way that results in the Client deriving a benefit from pursuing the Claim.

  • Vulnerability means a weakness of an asset or mitigation that can be exploited by one or more threats.

  • Viability means that stage of human development when the life of the unborn child may be continued by natural or life-supportive systems outside the womb of the mother;

  • Impact means any effect caused by a proposed activity on the environment including human health and safety, flora, fauna, soil, air, water, climate, landscape and historical monuments or other physical structures or the interaction among these factors; it also includes effects on cultural heritage or socio-economic conditions resulting from alterations to those factors;