Prepaid Capitation definition

Prepaid Capitation means the aggregate of all prepaid capitation amounts paid in advance with respect to the Reinsured Policies determined in accordance with SAP and appropriately includable on line 22 of the Assets page of the 2000 NAIC Annual Statement Blank, on line 24 of the Assets page of the 2001 NAIC Annual Statement Blank, or in comparable line items on successor NAIC Annual Statement Blanks, in each case whether or not such prepaid capitation amounts are admitted assets for statutory reporting purposes.
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Prepaid Capitation means an arrangement whereby the dentist providing services is compensated through capitation on the basis of the presence of an enrollee regardless of whether services are provided.]
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Prepaid Capitation means an annual fixed premium per person paid in advance for a specified set of comprehensive health benefits.
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Examples of Prepaid Capitation in a sentence

  • An Enrollee’s Effective Date of Enrollment shall be the first day of the month in which the Enrollee’s name appears on the Prepaid Capitation Plan Roster and is enrolled in the Contractor’s Medicare Advantage Product for that month.

  • As of the Effective Date of Enrollment, and until the Effective Date of Disenrollment from the Contractor's Medicaid Advantage Plus Product, the Contractor shall be responsible for the provision and cost of the Medicaid Services as described in Appendix K-2 of this Agreement for Enrollees whose names appear on the Prepaid Capitation Plan Roster.

  • As of the Effective Date of Enrollment, and until the Effective Date of Disenrollment, the Contractor shall be responsible for the provision and cost of all care and services covered by the Benefit Package and provided to Enrollees whose names appear on the Prepaid Capitation Plan Roster, except as hereinafter provided.

  • Managed Care Organizations (also referred to as Prepaid Capitation Plans) cover the care of many Medicaid enrollees and may have other qualifications for participation and offer additional services.

  • MA Recipient Enrollment MA recipients will be enrolled in the Prepaid Capitation Program (PCP) Subsystem of WMS.

  • MESSAGE SEQUENCERESPONSEDESCRIPTION/COMMENTSRECIPIENT’S MEDICAIDCOVERAGE (contd.)ELIGIBLE PCPA response of “Eligible PCP” indicates coverage under a Prepaid Capitation Program (PCP).

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  • The Prepaid Capitation Plan (PCP) subsystem is updated for enrollment after that transaction.

  • As of the Effective Date of Enrollment, and until the Effective Date of Disenrollment from the Contractor's plan, the Contractor shall be responsible for the provision and cost of all care and services covered by the Benefit Package and provided to Enrollees whose names appear on the Prepaid Capitation Plan Roster, except as herein after provided.

  • The Medicaid program does not reimburse for any service that is excluded from the benefit package of the FHP Managed Care Plan.MC MANAGED CARE COORDINATORELIGIBLE PCPA response of “Eligible PCP” indicates coverage under a Prepaid Capitation Program (PCP).

Related to Prepaid Capitation

  • Capitation means the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made to the Contractor for the performance of all of the Contractor’s duties and obligations pursuant to this Contract.

  • Capitation rate means the fee the department pays monthly to a participating health or dental plan for each enrollee for the provision of covered medical or dental services whether or not the enrollee received services during the month for which the fee is intended.

  • Prepaid Card means the MasterCard Prepaid Card that you have purchased from us;

  • Prepaid wireless calling service means a telecommunications service that provides the right to utilize mobile wireless service as well as other non-telecommunications services, including the download of digital products delivered electronically, content and ancillary services, which must be paid for in advance that is sold in predetermined units or dollars of which the number declines with use in a known amount.

  • 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.

  • Prepaid calling service means the right to access exclusively telecommunications services, which must be paid for in advance and which enables the origination of calls using an access number or authorization code, whether manually or electronically dialed, and that is sold in predetermined units or dollars of which the number declines with use in a known amount.

  • Poverty line means the nonfarm federal poverty line for the continental United States, as defined by the federal department of labor under 42 USC 9902 (2).

  • Balance billing means charging or collecting an amount in excess of the Medicaid, Medicare, or contracted reimbursement rate for services covered under a Medicaid, Medicare or employer sponsored beneficiary’s plan. “Balance Billing” does not include charging or collecting deductibles or copayments and coinsurance required by the beneficiary’s plan.

  • Skilled Nursing Care means services requiring the skill, training or supervision of licensed nursing personnel.

  • input service means any service used or intended to be used by a supplier in the course or furtherance of business;

  • Reference evapotranspiration or “ETo” means a standard measurement of environmental parameters which affect the water use of plants. ETo is given expressed in inches per day, month, or year as represented in Appendix C of these Guidelines, and is an estimate of the evapotranspiration of a large field of four to seven-inch tall, cool-season grass that is well watered. Reference evapotranspiration is used as the basis of determining the Maximum Applied Water Allowances.

  • Mail order pharmacy means a pharmacy licensed by this

  • Prepaid contract means any Contract that has terminated or been prepaid in full prior to its scheduled expiration date (including because of a Casualty Loss), other than a Defaulted Contract.

  • Unsubsidized Xxxxxxxx Loan means a Loan made pursuant to Section 428H of the Higher Education Act.

  • Busy Line Verification (BLV means a service whereby an End User requests an operator to confirm the busy status of a line.

  • payment initiation service means a service to initiate a payment order at the request of the payment service user with respect to a payment account held at another payment service provider;

  • Subsidized Xxxxxxxx Loan means a Loan for which the interest rate is governed by Section 427A(a) or 427A(d) of the Higher Education Act.

  • Medicaid means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of Title XIX of the Social Security Act, codified at 42 U.S.C. 1396 et seq.

  • Adult day care means a program for six (6) or more individuals, of social and health-related services provided during the day in a community group setting for the purpose of supporting frail, impaired elderly or other disabled adults who can benefit from care in a group setting outside the home.

  • Provider network means an affiliated group of varied health care providers that is established to provide a continuum of health care services to individuals;

  • Vapor balance system means a combination of pipes or hoses which create a closed system between the vapor spaces of an unloading tank and a receiving tank such that vapors displaced from the receiving tank are transferred to the tank being unloaded.

  • Voice mail service means an ancillary service that enables the customer to store, send or receive recorded messages. Voice mail service does not include any vertical services that the customer may be required to have in order to utilize the voice mail service.

  • Skilled Nursing Facility means an institution or part thereof that is licensed as a Skilled Nursing Facility by the State of Florida, and is accredited as a Skilled Nursing Facility by The Joint Commission or recognized as a Skilled Nursing Facility by the Secretary of Health and Human Services of the United States under Medicare.

  • Billing involves the provision of appropriate usage data by one Telecommunications Carrier to another to facilitate Customer Billing with attendant acknowledgments and status reports. It also involves the exchange of information between Telecommunications Carriers to process claims and adjustments.

  • Bid with Lowest Evaluated Cost means the bid quoting lowest cost amongst all those bids evaluated to be substantially responsive;

  • Earned value management system means an earned value management system that complies with the earned value management system guidelines in the ANSI/EIA-748.