Contracted health plan definition

Contracted health plan means a managed care organization with whom the department contracts to provide or arrange for the delivery of comprehensive health care services as authorized under this act.
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Contracted health plan means a health maintenance organization or health plan with which Customer has contracted to provide medical transportation services.
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Examples of Contracted health plan in a sentence

  • Notwithstanding the foregoing, the parties acknowledge that the price set forth in Exhibit A is not contingent upon the continuation of any specific Health Plan Agreement between Customer and a Contracted Health Plan.

  • Such reports must be sent via magnetic tape, electronic transmission, or diskette (or hard copy, if requested by a Contracted Health Plan) in a standard format established by Customer and the Contracted Health Plans, for each encounter that Member receives during the previous month.

  • Such encounter data reporting shall be segregated by Contracted Health Plan.

  • The publication AHCCCS Contracted Health Plan Technical Interface Guidelines describes the specific technical and procedural requirements for interfaces between AHCCCS and the Contractor and its subcontractors.

  • Refer to the AHCCCS Contracted Health Plan Technical Interface Guidelines available in the Bidder's Library for additional information.

  • Such information shall be complete and accurate and shall be provided to Customer (or to a Contracted Health Plan directly, if so directed by Customer) by the fifteenth (15th) day of the month, or if the fifteenth (15th) day falls on a weekend or a holiday, as of the next business day thereafter.

  • MPOWER, shall provide to Customer (or directly to the Contracted Health Plans, if so directed by Customer) reports containing information required by Customer and the applicable Contracted Health Plan, in accordance with the applicable Administrative Manual or Contracted Health Plan Amendment.

  • MPOWER shall promptly provide Customer (or the Contracted Health Plan, as appropriate) with all corrections and revisions of such encounter data.

  • MPOWER shall notify Customer within forty-eight (48) hours of receipt of any complaint received from a Member, a Member's representative, a Contracted Health Plan (if such complaint involves administrative services rendered by MPOWER pursuant to this Agreement) or a provider of medical transportation services in connection with services rendered by MPOWER hereunder.

  • Any claim that would be denied on the basis of Medical Necessity shall be referred to the Contracted Health Plan prior to denial.

Related to Contracted health plan

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

  • Qualified health plan means a health benefit plan that has in effect a certification that the plan

  • Allied Health Professional means a person registered as an allied health professional with the Health Professions Council;

  • Managed health care system means: (a) Any health care

  • 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.

  • 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.

  • Quality Assurance Plan or “QAP” shall have the meaning set forth in Clause 11.2;

  • Home health aide means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79

  • Retiree Health Plan means an "employee welfare benefit plan" within the meaning of Section 3(1) of ERISA that provides benefits to individuals after termination of their employment, other than as required by Section 601 of ERISA.

  • Quality Assurance Program means the overall quality program and associated activities including the Department’s Quality Assurance, Design-Builder Quality Control, the Contract’s quality requirements for design and construction to assure compliance with Department Specifications and procedures.

  • Approved abuse education training program means a training program using a curriculum approved by the abuse education review panel of the department of public health or a training program offered by a hospital, a professional organization for physicians, or the department of human services, the department of education, an area education agency, a school district, the Iowa law enforcement academy, an Iowa college or university, or a similar state agency.

  • 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;

  • Community mental health program means all mental health

  • Flexi Plan means any individual indemnity hospital insurance plan under the VHIS framework with enhancement(s) to any or all of the protections or terms and benefits that the Standard Plan provides to the Policy Holder and the Insured Person, subject to certification by the Government. Such plan shall not contain terms and benefits which are less favourable than those in the Standard Plan, save for the exception as may be approved by the Government from time to time.

  • New jobs training program or “program” means the project or projects established by a community college for the creation of jobs by providing education and training of workers for new jobs for new or expanding industry in the merged area served by the community college. The proceeds of the certificates, as authorized by the Act, shall be used only to fund program services related to training programs made necessary by the creation of new jobs.

  • State health plan means the employee and retiree insurance program provided for in Article 5, Chapter 11, Title 1.

  • Rural health clinic means a rural health clinic as defined under section 1861 of part C of title XVIII of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1395x, and certified to participate in medicaid and medicare.

  • Basic health plan means the plan described under chapter

  • Health and Safety Plan means a documented plan which addresses hazards identified and includes safe work procedures to mitigate, reduce or control the hazards identified;

  • Independent educational evaluation means an evaluation conducted by a qualified examiner who is not employed by the public agency responsible for the education of the child in question.

  • CMS means the Centers for Medicare and Medicaid Services.

  • Behavioral health means the promotion of mental health, resilience and wellbeing; the treatment of mental and substance use disorders; and the support of those who experience and/or are in recovery from these conditions, along with their families and communities.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with or employed by the health carrier.

  • Health and Human Services Commission or “HHSC” means the administrative agency established under Chapter 531, Texas Government Code, or its designee.

  • Procurement Plan means the Recipient’s procurement plan for the Project, dated April 2, 2010, and referred to in paragraph 1.16 of the Procurement Guidelines and paragraph 1.24 of the Consultant Guidelines, as the same shall be updated from time to time in accordance with the provisions of said paragraphs.