Managed Care Services definition

Managed Care Services means any system of health care delivery that attempts to control

Managed Care Services means the administration or management of a health care, pharmaceutical, vision or dental Plan utilizing cost control mechanisms, including, but not limited to utilization review, case management, disease management, pharmacy management, the use of a preferred provider medical, vision or dental network, or a health maintenance organization.

Managed Care Services means the management or administration by any entity that is not an Insured of any Sponsored Plan that is a health care, pharmaceutical, vision or dental plan, utilizing cost control mechanisms.

Examples of Managed Care Services in a sentence

• The Managed Care Services listed below require pre-certification, even if the Participant is using an in-network provider.

• Mail to:BlueChoice HealthPlan Attn: Transition of CareP.O. Box 6170 Columbia, SC 29260-6170Upon receipt of the request form, our Managed Care Services department will review and evaluate the information.

• Services covered under stop-loss provisions between EOHHS and the MCO in the Performance Period, as specified in the EOHHS/MCO Contract for Medicaid Managed Care Services.

• This LOD will sunset upon inclusion in the Medicaid Managed Care Services Agreement.

• TPA will support and employ a data exchange facility using Secure File Transfer Protocol (SFTP) security protocols no later than ninety (90) days following the date of execution of Managed Care Services agreement, unless otherwise mutually agreed by the parties.

More Definitions of Managed Care Services

Managed Care Services means and include any or all of the Company's managed care transaction services, which include claims submission, on-line (batch and real-time) eligibility, benefit plan detail, roster distribution, remittance advice distribution, online claims inquiry, electronic referral/pre-certification and authorization, and encounter submission, all as provided pursuant to the Managed Care Transaction Contract.

Managed Care Services. Means the Service Provider’s installation and hosting of the Software for the exclusive benefit of the Service Provider Customer.

Managed Care Services means any system of health care delivery that attempts to control or coordinate use of health care services in order to contain health care expenditures or improve quality of health care services.

Managed Care Services means a Third-Party Service Provider’s administration or management of a health care, pharmaceutical, vision or dental Sponsored Plan utilizing cost control mechanisms, including, but not limited to, utilization review, case management, disease management, pharmacy management, the use of a preferred provider medical, vision or dental network, or a health maintenance organization. Managed Care Services will not include (1) any services provided by a Self-Administered Plan and (2) any acts, errors or omissions in the rendering of or failure to render Medical Services by an Insured.

Managed Care Services means the administration or management of a health care plan utilizing cost control mechanisms, including, but not limited to, utilization review, case management, disease management, or the use of a preferred provider network; provided that Managed Care Services does not include: (i) any services provided by a Self Administered Plan; or (ii) any acts, errors, or omissions in the rendering of or failure to render Medical Services by an Insured.

Managed Care Services. Fees for services that follow are specific to individual County workers’ compensation claims and are paid to Contractor off the respective claim(s) as either an allocated or medical expense, as appropriate.

Managed Care Services means the services specified in Exhibit A to this Agreement.