Selective contracting arrangement definition

Selective contracting arrangement means an arrangement in which a health service corporation participates in selective contracting with one or more providers, and which arrangement contains reasonable benefit differentials, including, but not limited to, predetermined fee or reimbursement rates for covered benefits applicable to participating and nonparticipating providers.
Selective contracting arrangement means an arrangement in
Selective contracting arrangement means an arrangement in which a benefits payer participates in selective contracting with one or more participating health care providers or organized delivery systems, and which arrangement contains reasonable benefit differentials, including, but not limited to, predetermined fee or reimbursement rates for covered services applicable to participating and nonparticipating health care providers and organized delivery systems.

Examples of Selective contracting arrangement in a sentence

  • He explained that this can be budgeted; however, certain rules apply through the Federal Governments equitable sharing program, and funds can only be used for certain things.

  • The law leaves those issues for the Commissioner to address in regulations adopted to administer and enforce the law consistent with the stated goals— "health care cost containment and preserv[ation] of quality care." N.J.S.A. 17B:27A-54.N.J.A.C. 11:22-5.2 provides that "'Selective contracting arrangement contract' .


More Definitions of Selective contracting arrangement

Selective contracting arrangement means an agreement for the
Selective contracting arrangement or "SCA" means an arrangement for the payment of predetermined fees or reimbursement levels for covered services by the carrier to [preferred] network providers, [or preferred provider organizations] HMOs, certified ODSs, licensed

Related to Selective contracting arrangement

  • Collective Agreement means a written agreement concerning terms and conditions of employment or any other matter of mutual interest concluded by one or more registered trade unions, on the one hand and, on the other hand-

  • Prospective contractor means a person who is subject to the competitive sealed proposal process set forth in the Procurement Code or is not required to submit a competitive sealed proposal because that person qualifies for a sole source or a small purchase contract.

  • Collective Bargaining Agreement means any written or oral agreement, memorandum of understanding or other contractual obligation between the Company or any of its Subsidiaries and any labor organization or other authorized employee representative representing Service Providers.

  • Life-of-the-unit, firm power contractual arrangement means a unit participation power sales agreement under which a utility or industrial customer reserves, or is entitled to receive, a specified amount or percentage of nameplate capacity and associated energy from any specified unit and pays its proportional amount of such unit's total costs, pursuant to a contract:

  • Construction Service Agreement means either an Interconnection Construction Service Agreement or an Upgrade Construction Service Agreement.

  • Management Plan means a plan to manage the activities and protect the special value or values in an Antarctic Specially Protected Area or an Antarctic Specially Managed Area.