Out-of-Network Provider Reimbursement. The Contractor shall reimburse any out-of-network provider’s claim for authorized services provided to Hoosier Healthwise members at a rate it negotiates with the out- of-network provider, or the lesser of the following: ▪ The charges billed by the provider; or ▪ 100% of the established Indiana Medicaid FFS reimbursement rates that exist for participating IHCP providers at the time the service was rendered.
Appears in 4 contracts
Samples: Contract #0000000000000000000069680, Contract #0000000000000000000069768, Contract #0000000000000000000069716
Out-of-Network Provider Reimbursement. The Contractor shall reimburse any out-of-network provider’s claim for authorized services provided to Hoosier Healthwise members at a rate it negotiates with the out- ofout-of- network provider, or the lesser of the following: ▪ The charges billed usual and customary charge made to the general public by the provider; or ▪ 100% of the The established Indiana Medicaid FFS reimbursement rates that exist for participating IHCP providers at the time the service was rendered.
Appears in 3 contracts
Samples: Contract #0000000000000000000032139, Contract #0000000000000000000032137, Contract
Out-of-Network Provider Reimbursement. The Contractor shall reimburse any out-of-network provider’s claim for authorized services provided to Hoosier Healthwise members at a rate it negotiates with the out- out-of-network provider, or the lesser of the following: ▪ The charges billed by the provider; or ▪ 10098% of the established Indiana Medicaid FFS reimbursement rates that exist for participating IHCP providers at the time the service was rendered.
Appears in 3 contracts
Samples: Professional Services Contract Contract #0000000000000000000069716, Professional Services Contract Contract, Professional Services Contract Contract #0000000000000000000069767
Out-of-Network Provider Reimbursement. The Contractor shall reimburse any out-of-network provider’s claim for authorized services provided to Hoosier Healthwise members at a rate it negotiates with the out- ofout-of- network provider, or the lesser of the following: ▪ The charges billed usual and customary charge made to the general public by the provider; or ▪ 100% of the The established Indiana Medicaid FFS reimbursement rates that exist for participating IHCP providers at the time the service was rendered.
Appears in 3 contracts
Samples: Contract #0000000000000000000032137, Contract #0000000000000000000032139, Contract
Out-of-Network Provider Reimbursement. The Contractor shall reimburse any out-of-network provider’s claim for authorized services provided to Hoosier Healthwise members at a rate it negotiates with the out- out-of-network provider, or the lesser of the following: ▪ The charges billed by the provider; or EXHIBIT 1 SCOPE OF WORK – HOOSIER HEALTHWISE ▪ 10098% of the established Indiana Medicaid FFS reimbursement rates that exist for participating IHCP providers at the time the service was rendered.
Appears in 1 contract
Samples: Professional Services Contract Contract #0000000000000000000069680
Out-of-Network Provider Reimbursement. The Contractor shall reimburse any out-of-network provider’s claim for authorized services provided to Hoosier Healthwise members at a rate it negotiates with the out- out-of-network provider, or the lesser of the following: ▪ The charges billed usual and customary charge made to the general public by the provider; or ▪ 100% of the The established Indiana Medicaid FFS reimbursement rates that exist for participating IHCP providers at the time the service was rendered.
Appears in 1 contract
Samples: Professional Services Contract Contract #0000000000000000000018314
Out-of-Network Provider Reimbursement. The Contractor shall reimburse any out-of-network provider’s claim for of- authorized services provided to Hoosier Healthwise members at a rate it negotiates with the out- ofout-of- network provider, or the lesser of the following: ▪ The charges billed usual and customary charge made to the general public by the provider; or ▪ 100% of the The established Indiana Medicaid FFS reimbursement rates that exist for participating IHCP providers at the time the service was rendered.
Appears in 1 contract
Samples: Contract