Grouping Methodology. When the MCOP uses a grouping methodology to pay inpatient and/or outpatient hospital claims, or ambulatory surgery center (ASC) claims, they are expected to utilize the same grouper software and inpatient only procedure listing (determined by Medicare and 3M) that ODM uses to process fee-for-service claims.
Appears in 13 contracts
Samples: The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan, The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan, The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan
Grouping Methodology. When the MCOP MCP uses a grouping methodology to pay inpatient and/or outpatient hospital claims, or ambulatory surgery center (ASC) claims, they are expected to utilize the same grouper software and inpatient only procedure listing (determined by Medicare and 3M) that ODM uses to process fee-for-service claims.
Appears in 11 contracts
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan, Ohio Medical Assistance Provider Agreement for Managed Care Plan, Ohio Medical Assistance Provider Agreement for Managed Care Plan
Grouping Methodology. When the MCOP MCP uses a grouping methodology to pay inpatient and/or outpatient hospital claims, or ambulatory surgery center (ASC) claims, they are expected to utilize the same grouper software and inpatient only procedure listing (determined by Medicare and 3M) version that ODM uses to process fee-for-service claims.
Appears in 4 contracts
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan, Ohio Medical Assistance Provider Agreement for Managed Care Plan, Ohio Medical Assistance Provider Agreement for Managed Care Plan
Grouping Methodology. When the MCOP uses a grouping methodology to pay inpatient and/or outpatient hospital claims, or ambulatory surgery center (ASC) claims, they are expected to utilize the same grouper software and inpatient only procedure listing (determined by Medicare and 3M) version that ODM uses to process fee-for-service claims.
Appears in 1 contract
Samples: The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan
