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
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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.
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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.
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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.

  • The accuracy, completeness, and truthfulness of all data and information that are generated or submitted by the ACO, Participant Providers, Preferred Providers, or other individuals or entities performing functions or services related to ACO Activities or Marketing Activities, including any quality data or other information or data relied upon by CMS in determining the ACO’s eligibility for, and the amount of Shared Savings, or the amount of Shared Losses or Other Monies Owed.

  • Documentation requests sent to the ACO, Participant Providers, and/or Preferred Providers, including surveys and questionnaires.

  • ACOs must seek approval from the FTC or DOJ if any of the ACO’s participants has a PSA share of more than 50 percent, and any other ACO Participant in the same specialty draws patients from that PSA.

  • ACO Participant: A Health Care Provider or entity identified by a tax identification number (TIN) through which one or more Health Care Providers bill, that alone or together with one or more other ACO Participants comprise an ACO that has received HPC ACO certification, including provisional certification.

  • 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.

  • An Eligible Entity may receive one award as the Applicant and also participate in a different award as a Partner (e.g., a CHART eligible hospital may submit a proposal as the Applicant for Track 2b and also participate in a proposal submitted by an ACO in which the hospital is an ACO Participant).

  • Steward St. Anne’s Hospital Corporation (the “Hospital”), a Next Generation ACO Participant, Prima Care, P.C. (“Medical Group”) and Sadip Pant, M.D. (“Physician”) entered into a Physician Recruitment Agreement dated Feburary 26, 2018 pursuant to which the Hospital provided the Physician, through the recruiting Medical Group, with recruitment assistance to facilitate the Physician’s recruitment into the SICN Next Generation ACO.

  • To this end, we use monolingual lexical re- sources in English as an external reference, and compare it to the English CEFRLex.

  • 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.


More Definitions of ACO participant

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

  • Key participant means a sole proprietor, a partner in partnership, or a person with executive managerial control in a corporation. A person with executive managerial control includes persons such as a chief executive officer, chief operating officer and chief financial officer. This definition does not include non-executive managers such as farm, field, or shift managers.

  • 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.

  • Covered Participant means a Participant who is a “covered employee” as defined in Section 162(m)(3) of the Code, and the regulations promulgated thereunder, and any individual the Committee determines should be treated as such a covered employee.

  • 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 such employees or officers of the Company or a related entity of the Company as the Board may designate from time to time as eligible to participate in the Plan;

  • 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.

  • Major Participant means each Equity Member and each member of the Proposer’s organization: (a) with primary responsibility for design; (b) with primary responsibility for construction; or (c) with a proposed subcontract with a value greater than or equal to 5% of the contract price or $20 million, whichever is greater.

  • Qualified Participant means an individual who is a participant of Tier 2 and who meets 1 of the following requirements:

  • 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.

  • Employee Participant means an Employee who holds an outstanding Award under the terms of 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.