Withholds definition

Withholds means amounts withheld by the Company from payments of claims submitted by primary care physicians and specialists.
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Withholds as a noun, means the contractual practice of withholding a portion of a provider's claim reimbursement, or the setting aside of a predetermined percentage of premium income that eventually may be payable to a provider based upon a predetermined set of utilization review performance standards or claims dollar volumes.
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Withholds means a portion of any prepaid amount (usually a capitated rate or percent of premium) held back to insure Client against unforeseen medical risk within the population being served.
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Examples of Withholds in a sentence

  • Withholds of Contractor’s Capitation payment for the purposes of funding the incentive pool shall commence with the January 15, 2012 Capitation payment for the January 2012 service month.

  • Incentives and Withholds Withholds constitute 3% of the certified rates and are consistent with the Original certification.

  • Withholds will not begin until after the expiration of the Start-Up Period.

  • The JMC shall be provided with written notification of any missed TAGGED Company SLAs and/or any Service Charge Withholds or Direct Reimbursements being claimed and a meeting of the JMC shall be convened within ten (10) business days from the date written notification is given.

  • The role of the JMC with respect to Direct Reimbursements or Service Charge Withholds shall be: (1) to conduct a good faith review of an asserted deficiency, taking into account whether a failure on the part of the Reinsurer to provide necessary, complete or correct information to Company on a timely basis contributed to the asserted deficiency; and (2) to determine whether a deficiency has occurred and/or whether a Direct Reimbursement or Service Charge Withhold is warranted.

  • Withholds may be adjusted up or down, based on bed day performance, no more frequently than monthly.

  • The remaining percentage shall be paid as actual costs are incurred and subject to withholding and release of the final 10 percent in accordance with Progress Payment Withholds provision.

  • Incentives and Withholds Effective April 1, 2018, ODM implemented a quality withhold arrangement for the MMC program.

  • Buyer shall pay to participating physicians of Seller ("Physicians") $3.2 million of the amount withheld (or to be withheld) from Physicians for the calendar year 1995 (such $3.2 million amount is referred to as the "1995 Physician Withholds").

  • OTHER ITEMS 10 Hepatitis C Risk Pool 10 Incentives and Withholds 10 VI.