Examples of Related Group in a sentence
The MassHealth relative weight developed by EOHHS for each unique combination of All Patient Refined Diagnosis Related Group and severity of illness (SOI).
In-network provider flag Flag for whether the health plan has a network contract with service provider Yes/No In-network cost sharing flag Flag for whether the claim was paid applying in-network benefits to determine the patient's cost sharing Yes/No MS-DRG code DIAGNOSIS RELATED GROUP CODE represents the specific 'Diagnosis Related Group' (DRG) associated with a Claim.
See Chapter 7 for additional instructions. Language in Chapter 7 that has no direct application to the TOP contract does not apply (e.g., Diagnosis Related Group (DRG) validation reviews which are not applicable in any overseas location except Puerto Rico).
Individuals who qualify for coverage as part of a Related Group will be subject to the same premium collection and coverage termination provisions as other non-group (individual) subscribers to the Health Plan.
The Contractor may restrict enrollment to all affected individuals within a family, if more than one person is losing eligibility including family members in a Related Group.