Member Population definition

Member Population means the group of Attributed Members assigned to the Medical Panel or Program, as applicable; and whose costs under the relevant Anthem products(s) will be used to calculate MCBs, MCTs and MCPs pursuant to the Program (subject to criteria established by Anthem).
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Member Population means the group of Attributed Members assigned to Provider or Medical Panel and whose costs under the relevant Anthem product(s) as described in the Attachment will be used to calculate MPMLRs pursuant to the Program (subject to criteria established by Anthem).
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Member Population means the group of Medicare Advantage Attributed Members assigned to Provider or Medical Panel and whose costs under the relevant Anthem products(s) will be used to calculate MPMLRs pursuant to the Program (subject to criteria established by Anthem).
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Examples of Member Population in a sentence

  • Member Population Expected Enrolled Member Count Monthly RAPS File Production Fee (per Actual Enrolled Member) Triple-S Advantage, Inc.

  • Beginning on the SOW Effective Date Inovalon will charge a monthly base processing fee equal to the Prospective Advantage Processing Fee plus the Specific Measures Processing Fee (the “Base Processing Fee”) for the Member Population as noted in Table 1 below and a total member count related fee (the “PMPM Processing Fee”) as outlined within the Table 1 below.

  • Inovalon will charge a base fee for each CARA Process performed on each Member Population (the “CARA Processing Fees”) as outlined in Table 1 below.

  • Member Population Population Members Enrolled CARA Processing Fee Triple-S Advantage, Inc.

  • Inovalon shall work with designated Client personnel in the provision of a secure and complete transfer of Member Population data (each a “Health Plan Data Set”) between Client data to Inovalon via secure FTP portal using established transfer, compression, and encryption protocols.

  • The CARA Processing Fee will be invoiced at the initiation of the respective CARA Process Period and will be based on the Member Population from the Health Plan Data Set processed for the applicable CARA Process.

  • In consideration of the transition services, Inovalon will continue to invoice and Client will continue to pay the Base Processing Fee described in Section 9(a) of the SOW during the 3 month period following (a) the Termination Date or (b) January 1 with respect to Client’s Medicare Advantage members who are no longer part of the Member Population in accordance with the process outlined in Section 1(a) of this SOW (the “Transition Period”).

  • Beginning on the SOW Effective Date, Inovalon will charge a monthly fee equal to $5,101.18(the “CDR Monthly Maintenance Fee”) for the Member Population as noted in Table 1 below for the maintenance of the CDR and the ongoing import, validation, mapping, and cross-walking of client data into the CDR.

  • Member Population Population Members Enrolled Prospective Advantage Processing Fee Specific Measures Processing Fee PMPM Processing Fee Triple-S Advantage Inc.


More Definitions of Member Population

Member Population means the group of Attributed Members assigned to the Medical Panel, county, region, or state, as applicable; and whose costs under the relevant Empire products(s) will be used to calculate MCTs and MCPs pursuant to the Program (subject to criteria established by Empire.
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Member Population means the group of Attributed Members assigned to Provider as applicable; and whose costs and quality performance under the relevant Anthem products(s) will be used to calculate EPHC Essentials Performance Payment pursuant to the Program (subject to criteria established by Anthem).
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Member Population means the group of members comprised of the enrollees within the Medicare Advantage product line of Client for which Services are to be rendered, as designated by Client. Inovalon and Client agree that Inovalon will be the sole third party vendor only for the provision of the contracted Services for the Member Population as outlined in this SOW. With respect to the Member Population, Client may, at its discretion, complement or pursue additional initiatives using other contractors, but, Client agrees to share with Inovalon the results of any such complementary services. For clarity, such complementary services will not be in lieu of or decrease from the Services provided by Inovalon. Additionally, nothing in this definition prevents Client from revoking delegated Services in the event of a breach on the part of Inovalon. Client shall supply Inovalon with identifying information for those individual members included in the Member Population. Client has the right to exclude Medicare Advantage members from the Member Population, subject to the limitations described below. Client will ensure that the Member Population meets the minimum requirements listed below. Client will define the Member Population by providing Inovalon with written notice of a preliminary percentage estimate by October 1st preceding the applicable calendar year, a final percentage by November 1st preceding the applicable calendar year, and the actual members within the Member Population within one week of December 7th preceding the applicable calendar year. The parties acknowledge that the flexibility to define the Member Population may affect the ability of Inovalon to meet certain return on investment provisions in a particular SOW, and this will be taken into consideration when measuring the return on investment requirements. The Member Population as defined herein applies only to Encounter Facilitations and Supplemental Member Encounters. The Member Population for Encounter Support as described in Section 6(b) of the SOW and the analytics described in Section 5 of the SOW is defined as all unique members enrolled in all health plans within any applicable product line of Client during the applicable date of service period for which the Services are rendered, including plans acquired through corporate transactions or otherwise.
Sample 1
Member Population means the group of Medicare Advantage Attributed Members assigned to the Program, as applicable; and whose quality performance under the relevant Anthem products(s) will be used to calculate EPHC Essentials Performance Payment pursuant to the Program (subject to criteria established by Anthem).
Sample 1
Member Population means the group of Medicare Advantage Attributed Members assigned to Provider or Medical Panel and whose costs under the relevant Anthem Blue Cross products(s) will be used to calculate MPMLRs pursuant to the Program (subject to criteria established by Anthem Blue Cross).
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Member Population means the group of Medicare Advantage Attributed Members assigned to Provider or Medical Panel and whose costs under the relevant Empire products(s) will be used to calculate MPMLRs pursuant to the Program (subject to criteria established by Empire).
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Related to Member Population

  • Population means the population as ascertained at the last preceding census of which the relevant figures have been published;

  • Stationary beam radiation therapy means radiation therapy without displacement of one or more mechanical axes relative to the patient during irradiation.

  • Target Population means persons with low incomes who have one or more disabilities, including mental illness, HIV or AIDS, substance abuse, or other chronic health condition, or individuals eligible for services provided pursuant to the Lanterman Developmental Disabilities Services Act (Division 4.5 (commencing with Section 4500) of the Welfare and Institutions Code) and may include, among other populations, adults, emancipated minors, families with children, elderly persons, young adults aging out of the foster care system, individuals exiting from institutional settings, veterans, and homeless people.

  • Distribution Network Operator or “DSO” shall mean the operator of a Distribution Network.

  • Municipal Separate Storm Sewer System Management Program or "MS4 Program" means a management program covering the duration of a state permit for a municipal separate storm sewer system that includes a comprehensive planning process that involves public participation and intergovernmental coordination, to reduce the discharge of pollutants to the maximum extent practicable, to protect water quality, and to satisfy the appropriate water quality requirements of the CWA and regulations and the Act and attendant regulations, using management practices, control techniques, and system, design and engineering methods, and such other provisions that are appropriate.

  • PCP means Primary Care Provider.

  • Energy Use Intensity (EUI means the kBTUs (1,000 British Thermal Units) used per square foot of gross floor area.

  • Member Company means a “service recipient” as defined in Treasury Regulation § 1.409A-1(h)(3).

  • Participating Home Infusion Therapy Provider means a Home Infusion Therapy Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • District Level Anti-Ragging Committee means the Committee, headed by the District Magistrate, constituted by the State Government, for the control and elimination of ragging in institutions within the jurisdiction of the district.

  • Stormwater management measure means any practice, technology, process, program, or other method intended to control or reduce stormwater runoff and associated pollutants, or to induce or control the infiltration or groundwater recharge of stormwater or to eliminate illicit or illegal non-stormwater discharges into stormwater conveyances.

  • Local anesthesia means the elimination of sensation, especially pain, in one part of the body by the topical application or regional injection of a drug.

  • Project Management Plan means the management plan that (i) sets out a high level workplan to describe the manner in which the Design-Builder will manage the Project, including to address related matters such as traffic management and communications, and (ii) is prepared by or for the Design-Builder and submitted to the Owner;

  • Group-wide supervisor means the commissioner or other regulatory official designated as the group-wide supervisor for an internationally active insurance group under Section 31A-16-108.6.

  • Participating Prosthetic Provider means a Prosthetic Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Drug therapy management means the review of a drug therapy regimen of a patient by one or more pharmacists for the purpose of evaluating and rendering advice to one or more practitioners regarding adjustment of the regimen.

  • Cardiopulmonary resuscitation or "CPR" means artificial ventilation or external

  • Anesthesiologist means a physician granted clinical privileges to administer anesthesia.

  • Network plan means a policy of group health insurance offered by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. The term does not include an arrangement for the financing of premiums.