Paid Provider definition

Paid Provider means a provider who is issued a provider number for purposes of submitting medical assistance program claims for payment by the Authority.
Sample 1Sample 2Sample 3
Paid Provider means an individual or agency who meets the requirements to be a provider and who will provide services for a fee.
Sample 1Sample 2Sample 3
Paid Provider means a provider who meets the requirements in this rule for enrollment, billing, and payment.
Sample 1

Examples of Paid Provider in a sentence

  • Paid Provider # 6 187 192 Field Number Field Name Number of Bytes Starting Location Ending LocationN/ C Description/Mask 87.

  • The Contractor shall serve as the entry point for all initial Registered Child Development Home (CDH) and Child Care Assistance (CCA) Paid Provider Applications.

  • Example: Dates Of Service Services Provided Amount Charged Medicare ApprovedMedicare Paid Provider You May Be Billed See Notes SectionJohn Smith MD 123 West StreetJacksonville, FL 32231 06/06/951 Office/OutpatientVisit, Est (99214) $80.00 $57.25 $45.80 $0.00 b 06/06/951 Removal of Skin Lesion (11441) $65.00 $49.71 $14.20 $0.00 b,c 06/06/951 Destroy Benign/Premal.

  • In order to complete the 'Medicare Paid Provider' and 'Medicare Paid You' columns for MSP claims, you must apportion the total amount Medicare paid on the claim among the approved service lines.

  • Charged$25,0002) Negotiated Discount $10,0003) Allowed Amount (#1 - #2)$15,0004) Deductible$3005) Remaining Allowable (#3 - #4)$14,7006) In-Network Coinsurance (#5 x 10%)$1,4707) Plan Paid Provider (#5 - #6)$13,2308) Member Paid Provider (#4 + #6)$1,770Traditional Medical Plan.

  • This does not include providers enrolled through the use of the DMAP 3108 Managed Care Plan and FFS Non Paid Provider Application.

  • Paid: Provider Core # APPROVED THROUGH December 31, Reviewed By Date: KENTUCKY BOARD OF NURSING312 WHITTINGTON PARKWAY, SUITE 300LOUISVILLE, KY 40222-5172(502) 429-3300 APPLICATION FOR PROVIDER APPROVAL Instructions: Please provide the information requested and submit to the Kentucky Board of Nursing at the above address.

  • The provider numbers assigned by BCBSLA are located on the last page of the BCBSLA provider payment register in the Paid Provider # field.

  • WHPP Claim Amount – Would Have Paid Provider (WHPP) amount is the calculated amount for an adjudicated zero-paid claim that the DVHA would have paid if it were a FFS claim.

  • MEAL PREPARATION AND CLEAN UPIndependent Natural Support Paid Provider and Natural Support Paid Provider Only Habilitation OutcomeMake only one choice indicating whether the member eats alone or with family.

Related to Paid Provider

  • Approved provider means a provider of services registered with the appropriate association or organization to render services to a member and approved by Latrobe to render services to its members.

  • Designated provider means a person who:

  • Recognised Provider (Approved Provider) means a provider of services registered with the appropriate association or organization to render services to a member and approved Latrobe to render services to its members.

  • Affiliated provider means a health professional, licensed hospital, licensed pharmacy, or any other institution, organization, or person that has entered into a participating provider contract, directly or indirectly, with a health maintenance organization to render 1 or more health services to an enrollee. Affiliated provider includes a person described in this subdivision that has entered into a written arrangement with another person, including, but not limited to, a physician hospital organization or physician organization, that contracts directly with a health maintenance organization.

  • Qualified provider means a person or business experienced in the design, implementation, and installation of energy conservation measures. A qualified provider to whom the contract is awarded shall give a sufficient bond to the school district for its faithful performance.

  • Preferred Provider or “Network Provider” means a doctor, hospital, medical facility or other provider of health care which is included in a network which has been designated by the Fund to render health related services to Fund participants.

  • Registered Provider means a registered provider of social housing (see section 80 of the Housing and Regeneration Act 2008);

  • Medicaid Provider Agreement means an agreement entered into between a state agency or other such entity administering the Medicaid program and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicaid patients in accordance with the terms of the agreement and Medicaid Regulations.

  • Hub Provider means an entity that (i) provides Common Channel Signaling (SS7) connectivity between the networks of service providers that are not directly connected to each other; or (ii) provides third party database services such as LIDB. The SS7 messages received by Hub Providers are accepted or rejected by the Hub Provider depending on whether a contractual arrangement exists between the Hub Provider and the message originator (sender) and whether the message originator has contracted for the type of SS7 messages being submitted for transmission to the Hub Provider.

  • New Provider means any replacement service provider or providers engaged to provide the Services (or part thereof) or substantially similar services or the Authority itself where the Services or substantially similar services or part thereof continue to be provided by the Authority after partial termination, termination or expiry of this Contract;

  • Related provider trust means a titling trust or other trust established by a licensed viatical settlement provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. The trust shall have a written agreement with the licensed viatical settlement provider under which the licensed viatical settlement provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files related to viatical settlement transactions available to the commissioner as if those records and files were maintained directly by the licensed viatical settlement provider.

  • Participating provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

  • Provider is any individual or company that provides professional or technical services.

  • First-tier Subcontractor means any Subcontractor that has a contract with the General Contractor.

  • Preferred Provider Organization or "PPO" means an entity through which a group of health care providers, such as doctors, hospitals and others, agree to provide specific medical and hospital care and some related services at a negotiated price.

  • Local Service Provider (LSP) is the LEC that provides retail local Exchange Service to an End User. The LSP may or may not provide any physical network components to support the provision of that End User’s service.

  • Third Party Contractor as used in the Student Data Protection Act and “Operator” as used in COPPA. De-Identified Information (DII): De-Identification refers to the process by which the Contractor removes or obscures any Personally Identifiable Information (“PII”) from Education Records in a way that removes or minimizes the risk of disclosure of the identity of the individual and information about them.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Professional Provider means a Physician, Dentist, Podiatrist, Psychologist, Chiropractor, Optometrist or any Provider designated by the Claim Administrator or another Blue Cross and/or Blue Shield Plan.

  • Services Provider means Owl Rock Capital Corporation, or any successor in such capacity in accordance with the Corporate Services Agreement.

  • Subcontractor means any supplier, distributor, vendor, or firm that furnishes supplies or services to or for a prime contractor or another subcontractor.

  • Medical provider means a medical service provider, a hospital, a medical clinic, or a vendor of medical services.

  • Service Subcontract means a subcontract primarily for the furnishing of services, to or for a recipient of Assistance, except where services are incidental to the delivery of products, equipment or commodities. A contract for the purchase or lease of goods, products, equipment, supplies or other property is not a “service subcontract” for the purposes of this definition.

  • Training provider means an organization meeting the eligibility conditions as mentioned in Data Sheet and selected in accordance with the criteria set forth for the purpose.

  • Third-party logistics provider means a person that provides or coordinates warehousing of or other logistics services for a drug or device in interstate commerce on behalf of a manufacturer, wholesale distributor, or dispenser of the drug or device but does not take ownership of the product or have responsibility for directing the sale or disposition of the product.