Cost outlier definition

Cost outlier means cases which have an extraordinarily high cost as established in 79.1(5)“f,” so as to be eligible for additional payments above and beyond the initial DRG payment.
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Cost outlier means services provided during a single visit that have an extraordinarily high cost as established in paragraph “g” and are therefore eligible for additional payments above and beyond the base APC payment.
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Cost outlier means cases which have an extraordinarily high cost as established in paragraph
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Examples of Cost outlier in a sentence

  • Cost outlier payments are not available for cases reimbursed using the level-of-care methodology except for burn cases that exceed the established threshold.

  • Cost outlier payments shall be paid on short stay outlier cases that qualify as a cost outlier.

  • Cost outlier cases are determined according to a threshold established by the office.

  • Cost outlier payments may be subject to adjustment in cases of suspected fraud and/or abuse.

  • Cost outlier status does not depend on length of stay as such, but in practice cost outlier stays tend to be long stays—hence the requirement for concurrent review on stays that exceed 19 days.

  • When a design alternative is implemented with very effective manners, the associated frequency or probability parameter would be reduced to very low value, e.g. 10-7 ~ 10-8 or even close to zero with optimistic perspectives.

  • For post acute care special pay transfer DRGs Cost outlier payment + the minimum of: a.

  • Cost outlier payments will be made to stays that qualify as a cost outlier stay, which will be determined by comparing the hospital’s estimated loss on a particular stay with the cost outlier threshold amount.

  • Corporate Member intending to send their authorized representatives to attend the Meeting pursuant to Section 113 of the Companies Act, 2013 are requested to send a certified copy of the relevant Board Resolution together with specimen signatures of those representative(s) authorized under the said resolution to attend and vote on their behalf at the Meeting.

  • Cost outlier" means an additional payment for unusually high cost cases that exceeds the cost outlier thresholds as set forth in ARM 37.86.2916.


More Definitions of Cost outlier

Cost outlier means cases which have an extraordinarily high cost as established in 79.1(5)“f,” so as to be eligible for additional payments above and beyond the initial DRG payment. “Critical access hospital” or “CAH” means a hospital licensed as a critical access hospital by the
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Cost outlier means cases which have an extraordinarily high cost as established in 79.1(5)“f,” so as to be eligible for additional payments above and beyond the initial DRG payment. “Diagnosis-related group (DRG)” shall mean a group of similar diagnoses combined based on pa-
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Cost outlier means cases which services provided during a single visit that have an extraordinarily high cost as established in paragraph “g” and, thus, are therefore eligible for additional payments above and beyond the base APG APC payment.
Sample 1Sample 2Sample 3
Cost outlier means an additional payment for unusually high cost cases that exceeds the cost outlier thresholds as set forth in ARM 37.86.2916.
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Related to Cost outlier

  • Indirect cost rate proposal has the same meaning as in 44 Ill. Admin. Code Part 7000.

  • MONTHLY KILOMETREAGE STATEMENT CUM BILL means the format specified by the Company.

  • New business premium rate means, for each class of business as to a rating period, the lowest premium rate charged or offered, or which could have been charged or offered, by the small employer carrier to small employers with similar case characteristics for newly issued health benefit plans with the same or similar coverage;

  • Cost Estimate means the detailed projected expenditure, including material costs and overhead, equipment costs and overhead, labor costs and overhead, and all taxes associated with each major material and service component, required for a line extension. It shall also separately identify any incremental costs associated with providing premium services. The Company may, for the purpose of standardization, establish standard construction cost estimates, for basic or premium service plans, which shall not exceed, in any event, the average cost of constructing such line extensions in the area involved, in which case the term “cost estimate” as used in this section will be understood to mean the standard estimate thus established.

  • Net salvage value means the salvage value of property retired less the cost of removal.

  • Production Costs means those costs and expenditures incurred in carrying out Production Operations as classified and defined in Section 2 of the Accounting Procedure and allowed to be recovered in terms of Section 3 thereof.

  • Development Expenses means, with respect to SAIL Developments as well as HOME Developments when the HOME Development is also at least partially financed with a MMRB Loan (as defined in rule Chapter 67-21, F.A.C.), usual and customary operating and financial costs, such as the compliance monitoring fee, the financial monitoring fee, replacement reserves, the servicing fee and the debt service reserves. As it relates to SAIL Developments as well as HOME Developments when the HOME Development is also at least partially financed with a MMRB Loan (as defined in rule Chapter 67-21, F.A.C.) and to the application of Development Cash Flow described in subsections 67-48.010(5) and (6), F.A.C., as it relates to SAIL Developments or in paragraph 67-48.020(3)(b), F.A.C., as it relates to HOME Developments, the term includes only those expenses disclosed in the operating pro forma on an annual basis included in the final credit underwriting report, as approved by the Board, and maximum of 20 percent Developer Fee per year.

  • Cost Overrun means an obligation exceeding the maxi- mum capital expenditure authorized by an approval.

  • Salvaging means the removal of solid waste from a solid waste

  • Development Costs means costs incurred to obtain access to reserves and to provide facilities for extracting, treating, gathering and storing the oil and gas from reserves. More specifically, development costs, including applicable operating costs of support equipment and facilities and other costs of development activities, are costs incurred to:

  • Salvage value means the amount received for property retired, less any expenses incurred in connection with the sale or in preparing the property for sale, or, if retained, the amount at which the material recoverable is chargeable to materials and supplies, or other appropriate account.

  • Net Output means all energy expressed in kWhs produced by the Facility, less station and other onsite use and less transformation and transmission losses. Net Output does not include any environmental attributes.

  • Development Cost means the total of all costs incurred in the completion of a Development excluding Developer Fee, operating deficit reserves, and total land cost as typically shown in the Development Cost line item on the development cost pro forma.

  • Projected Recovery Amount The fair value of the estimated amount of subsequent recoveries, determined by Freddie Mac on the Termination Date, at its sole discretion, on the Credit Event Reference Obligations.

  • Bondable stranded costs rate order means one or more

  • Maintenance Capital Expenditures means, for any period, the portion of the aggregate amount of all Capital Expenditures of the Borrower for such period attributable to maintenance of property, plant or equipment of the Borrower and the Restricted Subsidiaries, as determined in good faith by a Responsible Officer of the Borrower.

  • Improvement Costs means any additional expenditure on a fixed asset that materially increases the capacity of the asset or materially improves its functioning or represents more than 10% of the initial depreciation base of the asset;

  • Project Costs means all allowable costs, as set forth in the applicable Federal cost principles, incurred by a recipient and the value of the contribu- tions made by third parties in accom- plishing the objectives of the award during the project period.

  • Cost Reimbursement means a contract which provides for a fee other than a fee based on a percentage of cost and under which a contractor is reimbursed for costs which are allowable and allocable in accordance with the contract terms.