ACO participant definition

ACO participant. Means an individual or group of ACO provider(s)/supplier(s), that is identified by a Medicare-enrolled TIN, that alone or together with one or more other ACO participants comprise(s) an ACO, and that is included on the list of ACO participants
ACO participant means an individual or group of ACO providers/suppliers that is identified by a Medicaid -enrolled provider number, that alone or together with one or more other ACO participants comprises the ACO, and that is included on the list of ACO participants required to be submitted as part of the program. An ACO participant bills Medicaid for services through its Medicaid enrolled provider number.
ACO participant and “Participant” means a healthcare provider who has, through a written agreement, agreed to participate in one or more ACO Programs and collaborate with an ACO to improve quality of care and patient experience, and manage costs, and, in general, attributes lives.

Examples of ACO participant in a sentence

  • ACO, Participant and Preferred Provider agree to participate in the Program as provided herein and are committed to performing ACO Activities, as that term is defined in the Agreement.

  • In the event this Program Addendum is terminated, non-renewed, or expires, ACO, Participant and Preferred Provider agree to complete a close-out process by furnishing all quality measure reporting data, including all claims or encounters for services rendered to Beneficiaries, to ACO.

  • An individual Primary Care Provider who assigns billing or collection to a group practice with a separate TIN must be exclusive to the same ACO and the ACO Participant that contains the Primary Care Provider must also be exclusive to the same ACO.

  • None of the provisions of this Agreement between or among ACO, Participant, Preferred Provider, Providers, or Payers is intended to create any relationship other than that of an independent contractor relationship.

  • If an ACO Participant and the associated Providers who assign xxxxxxxx to the ACO Participant do not contain Primary Care Providers, the ACO Participant and the non-Primary Care Providers are not required to be exclusive.

  • In the event this Program Addendum is terminated, non-renewed or expires, ACO, Participant and Preferred Provider agree to complete a close-out process by furnishing all quality measure reporting data, including all claims or encounters for services rendered to Beneficiaries, to ACO and to DVHA’s fiscal agent.

  • ACO, Participant and Affiliate agree to participate in the Program as provided herein and are committed to performing ACO Activities, as that term is defined in the Participant Agreement.

  • Therefore, in the event You (a) participate as an ACO Participant and (b) You also furnish Primary Care Services, You agree that You will not participate in any other MSSP accountable care organization, or similar Medicare initiative that involves shared savings payments, during the Term.

  • ACO Participant agrees to participate in and comply with the requirements of the Next Generation ACO Model, and shall provide health care services to Medicare beneficiaries assigned to TMIP’s ACO during the term of this Agreement.

  • A breach may include ACO Participant’s failure to comply with and implement the ACO’s care management processes and patient-centeredness criteria as periodically requested by TMIP as well as a failure by ACO Participant to comply with TMIP’s Participation Agreement with CMS or any of the requirements.


More Definitions of ACO participant

ACO participant means a provider or a supplier as identified by a Taxpayer Identification number.

Related to ACO participant

  • FTR Participant means any Market Participant that provides or is required to provide Collateral in order to participate in PJM’s FTR auctions.

  • CDS Participant means a participant in CDS that holds security entitlements in Units on behalf of beneficial owners of those Units;

  • Participant has the meaning specified in Section 10.06(d).

  • L/C Participant shall have the meaning provided in Section 3.3(a).

  • Plan Participant means a person who is eligible to receive, and is receiving, a pension benefit from the Plan.

  • Program participant means an individual certified by the secretary as a program participant under Iowa Code section 9E.3.

  • Inactive Participant means each Participant (other than a Retired Participant, Deceased Participant or Disabled Participant) who is not in active service as an Outside Director and is not actively employed by a Participating Company.

  • Active Participant means, with respect to any day or date, a Participant who is in Service on such day or date; provided, that a Participant shall cease to be an Active Participant (i) immediately upon a determination by the Committee that the Participant has ceased to be an Employee or Independent Contractor, or (ii) at the end of the Plan Year that the Committee determines the Participant no longer meets the eligibility requirements of the Plan.

  • Former Participant means a person who has been a Participant, but who has ceased to be a Participant for any reason.

  • U.S. Participant means a Participant who is a citizen of the United States or a resident of the United States, as defined in section 7701(a)(30)(A) and section 7701(b)(1) of the Code and any other Participant who is subject to tax under the Code with respect to compensatory awards granted pursuant to the Plan;

  • Non-U.S. Participant means any Participant that if it were a Lender would qualify as a Non-U.S. Lender.

  • Designated Participant means a key Employee of the Company or any other Participating Company who is designated by the Committee in writing to participate in the Program.

  • Other Participant means a cooperative project participant other than the United States.

  • Retired Participant means a person who has been a Participant, but who has become entitled to retirement benefits under the Plan.

  • Disabled Participant with respect to a loan if it has no right to exercise any voting or other control rights with respect to such loan (other than the right to approve amendments to the material economic terms of such loan).

  • Participating employee means an employee whose election to participate in a Plan has been approved by the employer.

  • Qualified Participant means a Participant who has attained age 55 and who has completed at least 10 years of participation in the Plan.

  • Eligible Employee means full-time and part-time employees in the bargaining unit who have completed four hundred and fifty (450) hours of service and who are not prohibited from contributing to the Plan by legislation or the Plan rules because of their age or because they are in receipt of a pension from the Plan.

  • Study Participant means a person recruited to participate in the Study.

  • A Participant or beneficiary ("claimant") who has not received benefits under the Plan that he or she believes should be paid shall make a claim for such benefits as follows:

  • Terminated Participant means a person who has been a Participant, but whose employment has been terminated other than by death, Total and Permanent Disability or retirement.

  • Eligible Participant means an employee, officer, consultant or director of the Company or any Affiliate.

  • Eligible employer means any municipality with a municipal

  • Current Participant means a person who participated in the Plan during the Class Period and had an Active Account on May 11, 2018.

  • Exchange Participant means (a) the Bank which is a person registered as a China Connect Exchange Participant (as defined in the SEHK China Connect Rules) by SEHK; or (b) where the context requires, any China Connect Exchange Participant (as defined in the SEHK China Connect Rules).

  • Section 162(m) Participant means any key Employee designated by the Administrator as a key Employee whose compensation for the fiscal year in which the key Employee is so designated or a future fiscal year may be subject to the limit on deductible compensation imposed by Section 162(m) of the Code.