Prepaid ambulatory health plan definition

Prepaid ambulatory health plan or "PAHP" means the same in these rules as defined at 42 C.F.R. § 438.2.
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Prepaid ambulatory health plan or "PAHP" means a DBM and/or an entity as per 42 C.F.R. § 438.2 that:
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Prepaid ambulatory health plan or "PAHP" means an organization with a certificate of authority or a certificate of registration from the office of the insurance commissioner. These organizations contract with the agency to provide prepaid health care services to enrollees under the agency's managed care programs. PAHPs do not have a compre- hensive risk contract and are not responsible for inpatient hospital or institutional services for its enrollees.
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Examples of Prepaid ambulatory health plan in a sentence

  • Prepaid ambulatory health plan (PAHP) has the meaning specified in § 438.2. Prepaid inpatient health plan (PIHP) has the meaning specified in § 438.2. Primary care case manager (PCCM) has the meaning specified in § 438.2. Significant business transaction means any business transaction or series of transactions that, during any one fiscal year, exceed the lesser of $25,000 and 5 percent of a provider's total operating expenses.

  • Prepaid ambulatory health plan (PAHP) has the meaning specified in § 438.2. Prepaid inpatient health plan (PIHP) has the meaning specified in § 438.2. Primary care case manager (PCCM) has the meaning specified in § 438.2. § 455.101 Definitions continued Significant business transaction means any business transaction or series of transactions that, during any one fiscal year, exceed the lesser of $25,000 and 5 percent of a provider's total operating expenses.

  • Prepaid ambulatory health plan (PAHP) (42 CFR 457.10) Capitation paymentOther (please explain)Describe population served: All children who are enrolled in CHIP will be mandatorily enrolled in the Healthy Smiles PAHP.

  • Louisiana provides state-approved dental services for eligible Medicaid enrollees through a Prepaid ambulatory health plan (PAHP).

  • If the application filed pursuant to this subsection accompanies an application that otherwise requires review by the planning commission, then the planning commission shall be the reviewing body for the application filed pursuant to this section.

  • Managed care organization (MCO), Pre- paid inpatient health plan (PIHP), Pre-paid ambulatory health plan (PAHP), and Primary care case management (PCCM) programs must comply with the 42 CFR Part 438 starting July 1, 2005.

  • Prepaid ambulatory health plan (PAHP) has the meaning specified in §438.2. Prepaid inpatient health plan (PIHP) has the meaning specified in §438.2. Primary care case manager (PCCM) has the meaning specified in §438.2.Significant business transaction means any business transaction or series of transactions that, during any one fiscal year, exceed the lesser of $25,000 and 5 percent of a provider's total operating expenses.

  • Prepaid ambulatory health plan (PAHP) (42 CFR 457.10) Capitation paymentOther (please explain) Describe population served: All children who are enrolled in CHIP will be mandatorily enrolled in the Healthy Smiles PAHP.

  • Prepaid ambulatory health plan (PAHP): As defined in 42 CFR §438.2, a PAHP is an entity that:1.

  • Managed care organization (MCO), Pre- paid inpatient health plan (PIHP), Pre-paid ambulatory health plan (PAHP), and Primary care case management (PCCM) programs must comply with Federal regulations at 42 CFR Part 438, starting July 1, 2005.

Related to Prepaid ambulatory health plan

  • Ambulatory means the condition of a person who immediately and without aid of another is physically or mentally capable of traveling a normal path to safety, including the ascent and descent of stairs.

  • Ambulatory review means utilization review of health care services performed or provided in an outpatient setting.

  • Nursing home-type patients means a patient who has been in hospital more than 35 days, no longer requires acute hospital care, cannot live independently at home or be looked after at home, and either cannot be placed in a nursing home or a nursing home place is not available.

  • Ambulatory surgical center means any public or private State licensed and approved (whenever required by law) establishment with an organized medical staff of Physicians, with permanent facilities that are equipped and operated primarily for the purpose of performing Surgical Procedures, with continuous Physician services and registered professional nursing service whenever a patient is in the facility, and which does not provide service or other accommodations for patients to stay overnight.

  • Dialysis solution means either the commercially available, unopened, sterile solutions whose

  • Ambulatory surgical facility means a facility that:  Is licensed by the state where it is located.  Is equipped and operated mainly to provide for surgeries or obstetrical deliveries.  Allows patients to leave the facility the same day the surgery or delivery occurs.

  • Health plan or "health benefit plan" means any policy,

  • Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.

  • Nonambulatory means a person who immediately and without the aid of another is not physically and mentally capable of traveling a normal path to safety, including the ascent and descent of stairs.

  • Hospice patient s family" means a hospice patient's immediate family members, including a spouse, brother, sister, child, or parent, and any other relative or individual who has significant personal ties to the patient and who is designated as a member of the patient's family by mutual agreement of the patient, the relative or individual, and the patient's interdisciplinary team.

  • Non-Administrator Ambulatory Surgical Facility means an Ambulatory Surgical Facility which does not meet the definition of an Administrator Ambulatory Surgical Facility.

  • graduate psychiatric nurse means a person whose name is entered on the register of graduate psychiatric nurses of the College of Registered Psychiatric Nurses of Manitoba. The terms of this Agreement shall be applicable to the graduate nurse, the graduate practical nurse, graduate psychiatric nurse, and graduate nurse practitioner, except as otherwise specified in the Collective Agreement.

  • Radiation therapist means a person, other than a Licensed Practitioner or Nuclear Medicine Technologist, who applies radiation to humans for therapeutic purposes under the supervision of a Licensed Practitioner;

  • Cannabis wholesaler means any licensed person or entity that purchases or otherwise obtains, stores, sells or otherwise transfers, and may transport, cannabis items for the purpose of resale or other transfer to either another cannabis wholesaler or to a cannabis retailer, but not to consumers.

  • Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.

  • Behavioral therapy means interactive therapies derived from evidence-based research, including applied behavior analysis, which includes discrete trial training, pivotal response training, intensive intervention programs, and early intensive behavioral intervention.

  • Basic health plan services means that schedule of covered

  • Ambulance service means an entity, its personnel and equipment including, but not limited to, automobiles, airplanes, boats or helicopters, which are licensed to provide Emergency medical and Ambulance services in the state in which the services are rendered.

  • Diagnostic Service means an examination or procedure performed to obtain information regarding the medical condition of an outpatient.

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.

  • Medical cannabis card means the same as that term is defined in Section 26-61a-102.

  • Moving beam radiation therapy means radiation therapy with any planned displacement of radiation field or patient relative to each other, or with any planned change of absorbed dose distribution. It includes arc, skip, conformal, intensity modulation and rotational therapy.

  • Pharmacy services means the practice of pharmacy as defined in chapter 18.64 RCW and includes any drugs or devices as defined in chapter 18.64 RCW.

  • Pre-Licensed Therapist means an individual who has obtained a Master’s Degree in Social Work or Marriage and Family Therapy and is registered with the BBS as an Associate CSW or MFT Intern acquiring hours for licensing. An individual’s registration is subject to regulations adopted by the BBS.

  • Community mental health program means all mental health

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