Common use of Provider Reimbursement Clause in Contracts

Provider Reimbursement. The Department may define an alternative payment methodology to which Contractor must adhere to when reimbursing Providers for provided services. 5.7.7.1 For all FQHCs and RHCs that elect to use the Department’s alternative payment methodology, Contractor shall pay contracted FQHCs and RHCs at least the Department’s full cost-based per-visit rate for Covered Services.

Provider Reimbursement. The Department may define an alternative payment methodology to which Contractor must adhere to when reimbursing Providers for provided services. 5.7.7.1 For all FQHCs and RHCs that elect to use the Department’s alternative payment methodology, Contractor shall pay contracted FQHCs and RHCs at least the Department’s full cost-based per-cost‐based per‐ visit rate for Covered Services. 5.7.7.2 Provider agreements shall require that Network Providers submit benefit expense claim data, as defined in 7.11.6.2, for all Covered Services provided to Enrollees.

Provider Reimbursement. The Department may define an alternative payment methodology to which Contractor must adhere to when reimbursing Providers for provided services.services.‌ 5.7.7.1 For all FQHCs and RHCs that elect to use the Department’s alternative payment methodology, Contractor shall pay contracted FQHCs and RHCs at least the Department’s full cost-based per-per- visit rate for Covered Services. 5.7.7.2 Provider agreements shall require that Network Providers submit benefit expense claim data, as defined in 7.11.6.2, for all Covered Services provided to Enrollees.