Outlier cases definition

Outlier cases means those DRG cases, including transfer cases, in which the hospital's adjusted operating cost for the case exceeds the hospital's operating outlier threshold for the case.
Sample 1Sample 2Sample 3
Outlier cases means those DRG cases, including transfer cases, in which the hospital’s adjusted operating cost for the case exceeds the hospital’s operating outlier threshold for the case.
Sample 1Sample 2Sample 3
Outlier cases means those DRG cases, including transfer cases, in which the hospital’s adjusted
Sample 1

Examples of Outlier cases in a sentence

  • Outlier cases will be reimbursed at the discharge rate plus 79 percent of the difference between the outlier threshold and the total cost of the case.

  • Outlier cases are not infrequent within each of the subtypes in this large observational cohort.

  • Facility-level adjustments include adjustments for the IPF’s wage index, rural location, teaching status, a cost-of-living adjustment for IPFs located in Alaska and Hawaii, and the presence of a qualifying emergency department (ED).The IPF PPS provides additionalpayment policies for: Outlier cases; interrupted stays; and a per treatment adjustment for patients who undergo electroconvulsive therapy (ECT).

  • For Outlier cases, EGID shall base its payment to the Facility using an Outlier Allowable Fee plus the MS-DRG Allowable Fee.

  • Outlier cases (Mature)Please refer to Appendix J for delay comments related to cases with an incomplete status and waiting more than 20 days for an evaluation, and cases with an incomplete status and waiting more than 40 days for restoration services.

  • Outlier cases are identified based on current case duration and a set of key characteristics that have been predictive of time to permanency (e.g., placement, age, drug involvement, etc.).

  • It was mainly because the Group, in accordance with the International Financial Reporting Standards No. 9 – Financial Instruments, has adjusted the notes receivables hold within a business model whose objective is achieved by both collecting contractual cash flows and selling of financial assets to debt instruments at fair value through other comprehensive income.

  • Outlier cases There are no class members to report waiting more than 100 days.

  • This document serves as notice to the public that the interim final rules, published on July 1,1985, to be included at 42 CFR Part 412, Subpart H are, by their own terms, revoked and will not become effective on August 1,1985.List of Subjects in 42 CFR Part 412 Cancer hospitals, Christian Sciencesanatoria, Discharges and transfers, Inpatient hospital services, Medicare, Outlier cases, Prospective payment, Referral centers, Renal transplantation centers, Sole community hospitals.

  • Definition of outliers Outlier cases are those that are not treated within the standard length of stay (LOS).

Related to Outlier cases

  • COVID-19 case means a person who:

  • Business Case means the written reasoning behind the initiation of a Procurement Project, prepared in the form set out in Part 1 of the Procurement Project Plan at Appendix A of the Procurement Project Planning Protocol.

  • Transfer case means the sealed box used to transport voted ballots to the

  • Final Approval Hearing means the hearing to be conducted by the Court to determine the fairness, adequacy, and reasonableness of the Settlement pursuant to Federal Rule of Civil Procedure 23 and whether to issue the Final Approval Order and Judgment.

  • Hearing aid means an instrument or device designed for regular and constant use in or proximate to the human ear and represented as aiding or improving defective human hearing.

  • Contested case hearing means a hearing under chapter 4 of the administrative procedures act of 1969, MCL 24.271 to 24.287, as authorized under chapter 5 of the administrative procedures act of 1969, MCL 24.291 to 24.292.

  • Chapter 11 Cases means (a) when used with reference to a particular Debtor, the case pending for that Debtor under chapter 11 of the Bankruptcy Code in the Bankruptcy Court and (b) when used with reference to all the Debtors, the procedurally consolidated chapter 11 cases pending for the Debtors in the Bankruptcy Court.

  • Day Case Procedure means a Medically Necessary surgical procedure for investigation or treatment to the Insured Person performed in a medical clinic, or day case procedure centre or Hospital with facilities for recovery as a Day Patient.

  • Final Approval Order means the entry of the order and final judgment approving the Settlement Agreement, implementing the terms of this Settlement Agreement, and dismissing the Class Action with prejudice, to be proposed by the Settling Parties for approval by the Court, in substantially the form attached as Exhibit D hereto.

  • Permanency hearing means a hearing, conducted with respect to a child who is in foster care, to determine the permanency plan for the child which includes:

  • Sale Hearing means the hearing conducted by the Bankruptcy Court to approve the transactions contemplated by this Agreement.

  • Appeals Board means the commissioners and deputy commissioners of the Workers’ Compensation Appeals Board acting en banc, in panels, or individually.

  • Appeals Panel means a panel appointed by the Chief Compliance Officer pursuant to Rule 620.

  • Closed panel plan means a plan that provides health benefits to covered persons primarily in the form of services through a panel of providers that have contracted with or are employed by the plan, and that excludes benefits for services provided by other providers, except in cases of emergency or referral by a panel member.

  • Off-Net Calls means any calls that are not (a) local calls, (b) 8xx outbound calls, or (c) On-Net Calls.

  • Appeal Board means the State Charter School Appeal

  • Moving beam radiation therapy means radiation therapy with any planned displacement of radiation field or patient relative to each other, or with any planned change of absorbed dose distribution. It includes arc, skip, conformal, intensity modulation and rotational therapy.

  • Fair Hearing means the State hearing provided to beneficiaries pursuant to Title 22, CCR, Sections 50951 and 50953. All fair hearings requested by beneficiaries shall comply with 42 CFR §§ 431.220(a)(5), 438.408(f), 438.414, and 438.10(g)(1).

  • Appeal Panel means a panel comprised of a chair and two individuals appointed by the Board to consider appeals under Chapter 7.

  • Double check valve assembly means an assembly composed of two single, independently acting, check valves including tightly closing shutoff valves located at each end of the assembly and suitable connections for testing the water tightness of each check valve.

  • Targeted case management means services that assist a beneficiary to access needed 2 medical, educational, social, prevocational, vocational, rehabilitative, or other community services. The 3 service activities may include, but are not limited to, communication, coordination and referral;

  • Bankruptcy Cases has the meaning set forth in the Recitals.

  • Review Panel means the panel, if any, appointed pursuant toRule 710 to review a completed Investigation Report and to determine whether a reasonable basis exists for finding a violation of the Rules and authorizing the issuance of a notice of charge pursuant to Rule 706.

  • Adjudicatory hearing means a hearing to determine:

  • Adult motion picture theater means a commercial establishment where, for any form of consideration, films, motion pictures, video cassettes, slides, or similar photographic reproductions are regularly shown which are characterized by the depiction or description of "specified sexual activities" or "specified anatomical areas."

  • business vertical means a distinguishable component of an enterprise that is engaged in the supply of individual goods or services or a group of related goods or services which is subject to risks and returns that are different from those of the other business verticals.