Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.
Managed Care Program means a managed care delivery system operated by the State as authorized under sections 1915(a), 1915(b), 1932(a), or 1115(a) of the Social Security Act. Managing Employee means a general manager, business manager, administrator, director, or other individual who exercises operational or managerial control over, or who directly or indirectly conducts the day-to-day operation of the Contractor. Marketing means any communication from Contractor, its employees, Network Providers, agents or Subcontractors to a Potential Enrollee that can reasonably be interpreted to influence the Potential Enrollee to enroll in Contractor’s Medicaid product, or either to not enroll in, or to disenroll from another PMHP’s Medicaid product. Marketing Materials means materials that are produced in any medium, by or on behalf of the Contractor, its employees, affiliated Providers, agents or Subcontractors to a Potential Enrollee that can reasonably be intended to market to Potential Enrollees. Medicaid means the medical assistance program authorized under Title XIX of the Social Security Act.
Managed Care Program. ’ means a program which provides co- ordination, direction and provision of health services to an identified group of individuals by providers, agencies or organizations.
Examples of Managed Care Program in a sentence
Two-thirds of this population is enrolled in the Managed Care Program.
If the member is enrolled in a BadgerCare Plus Managed Care Program at the time a prior authorized service is provided, ForwardHealth reimbursement will be allowed only if the service is not covered by the Managed Care Program.25.
DHCF implemented a Managed Care Program in the District to help provide quality care to DC Medicaid beneficiaries in a more economical manner.
The South Carolina Healthy Connections Program (a.k.a. the South Carolina Medicaid Managed Care Program) is administered by the South Carolina Department of Health and Human Services (SCDHHS) under the 1932(a) State Plan Authority (SSA Sec.
This section tells you about HPN’s Managed Care Program and which Covered Services require Prior Authorization.
More Definitions of Managed Care Program
Managed Care Program means services under the Medical Programs for which the Department pays a capitated payment to MCOs to cover the cost of covered medical services.
Managed Care Program means a program which provides
Managed Care Program or "managed care" or "MCP" means a health care delivery system organized to manage cost, utilization, and quality that is operated by a state as authorized under sections 1915(a), 1915(b), 1932(a), or 1115(a) of the Social Security Act and relevant state law.
Managed Care Program or "managed care" or "MCP" means a health care delivery system organized to manage cost, utilization, and
Managed Care Program. As defined in 42 C.F.R. § 438.2, a managed care delivery system operated by a State as authorized under sections 1915(a), 1915(b), 1932(a), or 1115(a) of the Act.
Managed Care Program means a managed care delivery system operated by the State as authorized under sections 1915(a), 1915(b), 1932(a), or 1115(a) of the Social Security Act. Managing Employee means a general manager, business manager, administrator, director, or other individual who exercises operational or managerial control over, or who directly or indirectly conducts the day-to-day operation of the Contractor. Marketing means any communication from Contractor, its employees, Network Providers, agents or Subcontractors to a Potential Enrollee that can reasonably be interpreted to influence the Potential Enrollee to enroll in Contractor’s Medicaid product, or either to not enroll in, or to disenroll from another Dental Plan’s Medicaid product. Marketing Materials means materials that are produced in any medium, by or on behalf of the Contractor, its employees, affiliated Providers, agents or subcontractors to a Potential Enrollee that can reasonably be intended to market to Potential Enrollees. Medicaid Fee for Service (FFS) means the delivery system or payment method for Medicaid members not enrolled in a Medicaid or CHIP managed care entity. Services are billed directly to and paid directly by Utah Medicaid.
Managed Care Program or "managed care" or "MCP" means a health care delivery system