Outlier payment definition

Outlier payment means the payment that is made when the outlier threshold is exceeded;
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Examples of Outlier payment in a sentence

  • Outlier payment amounts shall be equal to the marginal cost factor multiplied by the difference between the prospective cost per stay and the outlier threshold amount.

  • Outlier payment and transfer policies are not applied to state administered program psychiatric claims.

  • Rescinded IAB 5/30/01, effective 8/1/01.g. Outlier payment policy.

  • Outlier payment – An extra payment added to some claims priced via the DRG pricing methodology.

  • Outlier payment amounts shall be equal to the marginal cost factor multiplied bythe difference between the prospective cost per stayand the outlier threshold amount.

  • Outlier payment equals the eligible outlier costs multiplied by the outlier payment percentage as described in paragraph (I) of this rule.

  • Outlier payment is a payment for an entire episode, and therefore only carried at the claim level in paid claim history, not allocated to specific lines of the claim.

  • Outlier payment provisions are typically made for cases that are unpredictably expensive.

  • Outlier claim will reflect a zero pay for the earlier contract year with the Outlier payment reflected on the latest contract year, as reimbursement is based on the end date of the stage.

  • Outlier payment amounts shall be equal to a percentage of the difference between the prospective cost per stay and the outlier threshold amount.

Related to Outlier payment

  • Delta Payment means as it is described in this Agreement.

  • Transfer Payment Either or both of a Transfer Payment Made or a Transfer Payment Received.

  • Improper Payment means: (a) any payment, offer, gift or promise to pay or authorization of the payment or transfer of other things of value, including without limitation any portion of the compensation, fees or reimbursements received hereunder or the provision of any service, gift or entertainment, directly or indirectly to (i) a Government Official; (ii) any director, officer, employee or commercial partner of a Party or its Affiliates; or, (iii) any other person at the suggestion, request or direction or for the benefit of any of the above-described persons and entities, for purposes of obtaining or influencing official actions or decisions or securing any improper advantage in order to obtain, retain or direct business; (b) payments made and expenses incurred in connection with performance of obligations under this Agreement that are not made and recorded with sufficient accuracy, detail, and control to meet the standards in applicable Anti-Corruption Laws; or, (c) any other transaction in violation of applicable Anti- Corruption Laws.

  • Agreement Payment means a Payment paid or payable pursuant to this Agreement.

  • Application for Payment means Contractor’s monthly partial invoice for payment that includes any portion of the Work that has been completed for which an invoice has not been submitted and performed in accordance with the requirements of the Contract Documents. The Application for Payment accurately reflects the progress of the Work, is itemized based on the Schedule of Values, bears the notarized signature of Contractor, and shall not include subcontracted items for which Contractor does not intend to pay.

  • Contingent Payment means any payment that has been (or is required to be) ------------------ made under any of the following circumstances:

  • Transfer Payment Received As defined in Section 4.03.

  • Adjustment Payment shall have the meaning specified in Section 3.09(a).

  • Payment Cap For each Mortgage Loan, the percentage limit set forth in the related Mortgage Note concerning the maximum permitted increase in a monthly payment.

  • PAGA Payment means the penalties pursuant to PAGA that the Parties have agreed is a

  • Earnout Payment has the meaning set forth in Section 2.3(b).

  • Reimbursement Payment shall have the meaning given to that term in Subparagraph 2.02(c).

  • Completion Payment means the payment for the 20% of the Charges for each Apprenticeship that under the ESFA Rules is only paid once an Apprentice takes their end point assessment, including as the case may be Apprenticeships funded by Transferred Levy Funds;

  • Settlement Payment means the transfer, or contractual undertaking (including by automated clearing house transaction) to effect a transfer, of cash or other property to effect a Settlement.

  • AHYDO Catch-Up Payment means any payment on any Indebtedness that would be necessary to avoid such Indebtedness being characterized as an “applicable high yield discount obligation” under Section 163(i) of the Code.

  • Contingent Payments has the meaning set forth in Section 2.02(a).

  • Debit Payment means a particular transaction where a debit is made.

  • Due for Payment means with respect to an Insured Amount, the Distribution Date on which Insured Amounts are due and payable pursuant to the terms of the Agreement.

  • Closing Date Payment has the meaning set forth in Section 2.04(a)(i).

  • Capitation Payment means a payment the STATE makes periodically to the MCO for each Enrollee covered under the Contract for the provision of services as defined in Article 6 regardless of whether the Enrollee receives these services during the period covered by the payment.

  • Event Payments has the meaning set forth in Section 6.1(d).

  • Payment Amount has the meaning specified in Section 6.1.

  • Progress Payment means a payment by a public agency to a contractor for work in place under the terms of a construction contract.

  • Request for Payment means a payment application or declaration of expenditure submitted by the Member State to the Commission;

  • Interim Payment has the meaning specified in Section 10.1.

  • FILOT Payments means the amount paid or to be paid in lieu of ad valorem property taxes as provided herein.