{"component": "definition", "props": {"groups": [{"size": 9, "snippet_links": [{"key": "the-service", "type": "clause", "offset": [49, 60]}], "snippet": "means the physician or AHP who actually performs the service;", "samples": [{"hash": "cfI0K99MB03", "uri": "https://eregulations.ct.gov/eRegsPortal/Browse/getDocument?guid=%7BBB4F59FA-FF7B-470A-905C-BC95A24E2B5F%7D", "label": "eregulations.ct.gov", "score": 10.4058863792, "published": false}, {"hash": "jiprYin1YAl", "uri": "https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=ch7_phys.pdf&URI=Manuals/ch7_phys.pdf", "label": "www.ctdssmap.com", "score": 9.3655030801, "published": false}, {"hash": "3jybUqIPX4G", "uri": "https://eregulations.ct.gov/eRegsPortal/Browse/getDocument?guid=%7B20A0E155-0900-C497-9579-042448CFAB4B%7D", "label": "eregulations.ct.gov", "score": 8.1403148528, "published": false}], "hash": "632cd105538e35b9f1cc74be922e3997", "id": 1}, {"size": 9, "snippet_links": [{"key": "the-individual", "type": "clause", "offset": [6, 20]}], "snippet": "means the individual who personally delivers a care or service directly to a client.", "samples": [{"hash": "2itWvOcSihi", "uri": "https://humanservices.arkansas.gov/images/uploads/dbhs/DBHS_Behavioral_Health_Agency_Certification_-_FINAL_-_Updated_QBHP_Training.docx", "label": "humanservices.arkansas.gov", "score": 10.1704312115, "published": false}, {"hash": "i3n5tTmwKeD", "uri": "http://170.94.37.152/REGS/016.19.18-003P-18056.pdf", "label": "170.94.37.152", "score": 9.3080082136, "published": false}, {"hash": "g2w6Ugnjkq9", "uri": "https://humanservices.arkansas.gov/wp-content/uploads/Behavioral_Health_Agency_Certification_Manual_06012022.pdf", "label": "humanservices.arkansas.gov", "score": 9.1875427789, "published": false}], "hash": "bf178fde44ee0d427c9c9a738218f5ad", "id": 2}, {"size": 8, "snippet_links": [{"key": "licensed-practitioner", "type": "definition", "offset": [23, 44]}], "snippet": "means an Independently Licensed Practitioner who personally delivers a care or service directly to a client.", "samples": [{"hash": "6Agn1g9NOxR", "uri": "https://humanservices.arkansas.gov/wp-content/uploads/Posting-Packet-Interested-Persons-Rebalancing-IDD-BH-r210.pdf", "label": "humanservices.arkansas.gov", "score": 11.3874058864, "published": false}, {"hash": "gvtksnYDtHd", "uri": "https://humanservices.arkansas.gov/wp-content/uploads/Posting-Packet-Interested-Persons-Rebalancing-IDD-BH-r210-Revised-12-12-22.pdf", "label": "humanservices.arkansas.gov", "score": 11.3874058864, "published": false}, {"hash": "7zufJOazOFU", "uri": "https://humanservices.arkansas.gov/images/uploads/dbhs/DBHS_Independently_Licensed_Practitioner_Certification_FINAL.docx", "label": "humanservices.arkansas.gov", "score": 10.1704312115, "published": false}], "hash": "0fa1e82f9e53b1fe1b9bb2cbba506f55", "id": 3}, {"size": 6, "snippet_links": [{"key": "a-person", "type": "clause", "offset": [6, 14]}, {"key": "other-entity", "type": "clause", "offset": [77, 89]}, {"key": "the-provider", "type": "definition", "offset": [98, 110]}, {"key": "authority-to-delegate", "type": "clause", "offset": [141, 162]}, {"key": "fiduciary-responsibilities", "type": "clause", "offset": [163, 189]}, {"key": "billing-provider", "type": "definition", "offset": [195, 211]}, {"key": "billing-agent", "type": "definition", "offset": [225, 238]}, {"key": "to-obligate", "type": "definition", "offset": [240, 251]}, {"key": "claim-submissions", "type": "clause", "offset": [310, 327]}, {"key": "and-payments", "type": "clause", "offset": [342, 354]}, {"key": "medical-assistance-program", "type": "definition", "offset": [371, 397]}, {"key": "for-the-purposes-of", "type": "clause", "offset": [399, 418]}, {"key": "the-school", "type": "definition", "offset": [437, 447]}], "snippet": "means a person, agent, business, corporation, clinic, group, institution, or other entity that is the provider of a service or item with the authority to delegate fiduciary responsibilities to a billing provider, also termed billing agent, to obligate or act on the behalf of the performing provider regarding claim submissions, receivables, and payments relative to the Medical Assistance Program. For the purposes of these SBHS rules, the school medical (SM) provider is the performing provider.", "samples": [{"hash": "ibl6LS67XGY", "uri": "http://www.scesd.k12.or.us/wp-content/uploads/2020/09/School-Based-Health-Services-Rulebook-4.9.2020.pdf", "label": "www.scesd.k12.or.us", "score": 8.1498973306, "published": false}, {"hash": "6zoUXtUTKQc", "uri": "https://www.oregon.gov/oha/HSD/OHP/Policies/133-changes-040920.pdf", "label": "www.oregon.gov", "score": 8.1348391513, "published": false}, {"hash": "lrjydEYMaMY", "uri": "https://www.oregon.gov/oha/HSD/OHP/Policies/133rb070116.pdf", "label": "www.oregon.gov", "score": 6.4195756331, "published": false}], "hash": "4ff54ae9ad084b17af330e2aa770d66b", "id": 4}, {"size": 5, "snippet_links": [{"key": "an-individual", "type": "clause", "offset": [6, 19]}, {"key": "a-member", "type": "clause", "offset": [76, 84]}], "snippet": "means an individual enrolled in Medicaid who actually provides a service to a member;", "samples": [{"hash": "fqOmlhts8K4", "uri": "https://www.ctdssmap.com/CTPortal/Information/Get-Download-File?Filename=ch7_hosp_ip.pdf&URI=Manuals/ch7_hosp_ip.pdf", "label": "www.ctdssmap.com", "score": 7.4585900068, "published": false}, {"hash": "31VY495Bu6o", "uri": "https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=ch7_iC_hospital_V1.0.pdf&URI=Manuals/Ch7hospitalinpatient2015.pdf", "label": "www.ctdssmap.com", "score": 7.4585900068, "published": false}, {"hash": "aldlIPEW8Bu", "uri": "https://portal.ct.gov/-/media/sots/regulations/notices_of_intent/noi2014120302proposedregpdf.pdf?la=en", "label": "portal.ct.gov", "score": 7.4585900068, "published": false}], "hash": "69c4a2bd83d43f5ccb0528117d5f51c7", "id": 5}, {"size": 4, "snippet_links": [{"key": "direct-care-staff-member", "type": "definition", "offset": [10, 34]}, {"key": "providing-a-service", "type": "definition", "offset": [44, 63]}, {"key": "an-individual", "type": "clause", "offset": [67, 80]}, {"key": "residential-treatment-program", "type": "definition", "offset": [86, 115]}, {"key": "rehabilitative-service", "type": "definition", "offset": [140, 162]}], "snippet": "means the direct care staff member actually providing a service to an individual in a residential treatment program or separately billing a rehabilitative service to an individual residing in a residential treatment program;", "samples": [{"hash": "gfnmf6CNwB9", "uri": "https://www.oregon.gov/oha/HSD/OHP/Policies/172rb112619.pdf", "label": "www.oregon.gov", "score": 9.2881587953, "published": false}, {"hash": "lTHd25H4PT3", "uri": "https://www.oregon.gov/oha/HSD/OHP/Policies/172rb062819.pdf", "label": "www.oregon.gov", "score": 8.2881587953, "published": false}, {"hash": "3ErIDSKPK4I", "uri": "https://www.oregon.gov/oha/HSD/OHP/Policies/172-0705-0730-06282019.pdf", "label": "www.oregon.gov", "score": 7.7405886379, "published": false}], "hash": "2cbcf87cae6d77f6b795ff76fee05994", "id": 6}, {"size": 4, "snippet_links": [{"key": "grantee-agency", "type": "definition", "offset": [21, 35]}, {"key": "other-entity", "type": "clause", "offset": [40, 52]}, {"key": "department-of-mental-health", "type": "clause", "offset": [69, 96]}, {"key": "delivery-of", "type": "clause", "offset": [104, 115]}, {"key": "case-management-services", "type": "definition", "offset": [116, 140]}, {"key": "eligible-persons", "type": "clause", "offset": [144, 160]}], "snippet": "means any designated grantee agency, or other entity employed by the Department of Mental Health in the delivery of case management services to eligible persons.", "samples": [{"hash": "k3MDlUXeCtN", "uri": "https://eregulations.ct.gov/eRegsPortal/Browse/getDocument?guid=%7B62909190-2C66-444A-AD0F-C7AF41A58E99%7D", "label": "eregulations.ct.gov", "score": 10.4318959617, "published": false}, {"hash": "KIFJ8UBZR8", "uri": "https://eregulations.ct.gov/eRegsPortal/Browse/getDocument?guid=%7B167ECECD-C591-479D-8DCE-3929DC8D2AAB%7D", "label": "eregulations.ct.gov", "score": 10.3552361396, "published": false}, {"hash": "hRs0Y7VvFN4", "uri": "https://eregulations.ct.gov/eRegsPortal/Browse/getDocument?guid=%7B109FE155-0600-C253-A5DC-98644814AA96%7D", "label": "eregulations.ct.gov", "score": 8.1403148528, "published": false}], "hash": "b8f0feaf1a4a5b82175cefcdb332cf30", "id": 7}, {"size": 3, "snippet_links": [{"key": "licensed-practitioner", "type": "definition", "offset": [10, 31]}, {"key": "file-with-the-department", "type": "definition", "offset": [108, 132]}, {"key": "in-accordance-with", "type": "definition", "offset": [163, 181]}, {"key": "the-regulations", "type": "clause", "offset": [235, 250]}, {"key": "state-agencies", "type": "clause", "offset": [266, 280]}, {"key": "supervision-of", "type": "clause", "offset": [292, 306]}, {"key": "performed-by", "type": "clause", "offset": [330, 342]}], "snippet": "means the licensed practitioner or BCBA who: (A) is enrolled in Medicaid with a valid provider agreement on file with the department and (B) performs ASD services in accordance with sections 17b-262-1051 to 17b-262-1065, inclusive, of the Regulations of Connecticut State Agencies, including supervision of ASD treatment services performed by a technician;", "samples": [{"hash": "yXhhoL1DIS", "uri": "https://portal.ct.gov/-/media/Departments-and-Agencies/DSS/OLCRAH/14-07OperationalPolicyAutismSpectrumDisorderServices.pdf?la=en", "label": "portal.ct.gov", "score": 7.4955509925, "published": false}, {"hash": "axQCgF6AicP", "uri": "https://portal.ct.gov/-/media/sots/regulations/notices_of_intent/noi2014122901proposedregpdf.pdf?la=en", "label": "portal.ct.gov", "score": 7.4941820671, "published": false}, {"hash": "2BCKRqakC8Z", "uri": "https://portal.ct.gov/-/media/sots/regulations/nop_1226_2013_dss/nop14072014dsspdf.pdf?la=en", "label": "portal.ct.gov", "score": 7.4941820671, "published": false}], "hash": "3e7fd29de2a012ff4990fb73d9c5d458", "id": 8}, {"size": 1, "snippet_links": [{"key": "a-person", "type": "clause", "offset": [6, 14]}, {"key": "other-entity", "type": "clause", "offset": [77, 89]}, {"key": "the-provider", "type": "definition", "offset": [98, 110]}, {"key": "authority-to-delegate", "type": "clause", "offset": [141, 162]}, {"key": "fiduciary-responsibilities", "type": "clause", "offset": [163, 189]}, {"key": "billing-provider", "type": "definition", "offset": [195, 211]}, {"key": "billing-agent", "type": "definition", "offset": [225, 238]}, {"key": "to-obligate", "type": "definition", "offset": [240, 251]}, {"key": "claim-submissions", "type": "clause", "offset": [310, 327]}], "snippet": "means a person, agent, business, corporation, clinic, group, institution, or other entity that is the provider of a service or item with the authority to delegate fiduciary responsibilities to a billing provider, also termed billing agent, to obligate or act on the behalf of the performing provider regarding claim submissions,", "samples": [{"hash": "gjmYTGeWxaT", "uri": "https://www.oregon.gov/oha/HSD/OHP/Policies/133-changes-100520.pdf", "label": "www.oregon.gov", "score": 8.3757700205, "published": false}], "hash": "99fc3c25e561e9675fcdb86bbf57a5f5", "id": 9}, {"size": 1, "snippet_links": [{"key": "advanced-practice-registered-nurse", "type": "clause", "offset": [27, 61]}, {"key": "physician-assistant", "type": "definition", "offset": [63, 82]}, {"key": "licensed-clinical-social-worker", "type": "definition", "offset": [98, 129]}, {"key": "licensed-professional-counselor", "type": "clause", "offset": [131, 162]}, {"key": "licensed-marital-and-family-therapist", "type": "definition", "offset": [166, 203]}, {"key": "file-with-the-department", "type": "definition", "offset": [272, 296]}, {"key": "in-accordance-with", "type": "definition", "offset": [324, 342]}, {"key": "the-regulations", "type": "clause", "offset": [396, 411]}, {"key": "state-agencies", "type": "clause", "offset": [427, 441]}, {"key": "supervision-of", "type": "clause", "offset": [453, 467]}, {"key": "performed-by", "type": "clause", "offset": [491, 503]}, {"key": "scope-of-practice", "type": "definition", "offset": [569, 586]}], "snippet": "means the BCBA, physician, advanced practice registered nurse, physician assistant, psychologist, licensed clinical social worker, licensed professional counselor or licensed marital and family therapist who: (A) is enrolled in Medicaid with a valid provider agreement on file with the department; (B) performs ASD services in accordance with sections 17b-262-1051 to 17b-262-1065, inclusive, of the Regulations of Connecticut State Agencies, including supervision of ASD treatment services performed by a technician; and (C) provides services within such individual\u2019s scope of practice;", "samples": [{"hash": "8GHhbxvAGsq", "uri": "https://portal.ct.gov/-/media/sots/regulations/notices_of_intent/nod2015052101finalwordingpdf.pdf?la=en", "label": "portal.ct.gov", "score": 7.688569473, "published": false}], "hash": "bd540f4ea9477b55e46fd22bc4d8e0df", "id": 10}], "next_curs": "CmASWmoVc35sYXdpbnNpZGVyY29udHJhY3RzcjwLEhpEZWZpbml0aW9uU25pcHBldEdyb3VwX3Y1NiIccGVyZm9ybWluZy1wcm92aWRlciMwMDAwMDAwYQyiAQJlbhgAIAA=", "definition": {"size": 45, "snippet": "means the physician or AHP who actually performs the service;", "title": "Performing provider", "id": "performing-provider", "examples": ["Of these patients, 171were excluded for the following reasons: 1: <strong>Performing provider</strong> (Unique Physician Identification Number (UPIN)) was missing, 2: Date of surgery in NCH claims did not fall within 1 week of the date of surgery in MEDPAR claim or 3: Surgery claim reported in NCH claims did not match the pre-determined list of colon cancer surgery codes."], "related": [["performing-party", "Performing Party", "Performing Party"], ["training-provider", "Training provider", "Training provider"], ["hosting-provider", "Hosting Provider", "Hosting Provider"], ["new-provider", "New Provider", "New Provider"], ["participating-provider", "Participating Provider", "Participating Provider"]], "related_snippets": [], "updated": "2025-07-06T21:56:45+00:00"}, "json": true, "cursor": ""}}