AHCCCS Health Plan definition

AHCCCS Health Plan means an organization or entity agreeing through a direct contracting relationship with AHCCCS to provide the goods and services specified by contract in conformance with the stated contract requirements, AHCCCS statute and rules and federal law and regulations.
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AHCCCS Health Plan means an organization or entity that has a contract with AHCCCS to provide specified health-related goods and services in conformance with the stated requirements, Arizona statute and rules, and federal law and regulations.
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Examples of AHCCCS Health Plan in a sentence

  • Once approval is obtained the costs must shift to the AHCCCS Health Plan (subject to post-payment review) (see also – TPL waivers).

  • If the service authorizations requested through the AHCCCS Health Plan have not been approved or denied prior to the planned start date for the early intervention service on the IFSP, the service may be invoiced to ADES/AzEIP until the approval or denial from the health plan is received.

  • For those issues that cannot be resolved, parties indicated that they should be resolved in the Staff Report that is scheduled in the OSS OII.

  • In addition, presentations were made to the Arizona Medical Association Maternal Child Health Committee, the March of Dimes, AHCCCS Health Plan maternal child-health coordinators, and local public health officers.

  • Please contact your AHCCCS Health Plan for specific requirements and rates for billing or go to http://www.azahcccs.gov/commercial/ProviderBilling/rates/PCSrates.aspx for more information.Native American/Alaskan NativeYou may charge the Native American/Alaskan Native patient up to $21.33 per immunization, but if they are not able to pay, you must waive the administration fee.KidsCare:You cannot charge a KidsCare patient an administration fee.

  • Once approval is obtained the costs must shift to the AHCCCS Health Plan.

  • According to the current AHCCCS Health Plan Marketing Policy, Health Choice Arizona must have signed contracts with PCP’s, specialists, dentists, and pharmacies in order to be included in marketing outreach programs that target AHCCCS members.

  • If the services requested through the AHCCCS Health Plan have not been approved or denied prior to the planned start date for the early intervention service on the IFSP, or if the service will not start on the planned start date determined by the IFSP team, the service can be billed to AzEIP until the approval or denial from the health plan is received.

  • If an approval is obtained, the costs must then shift to the AHCCCS Health Plan (subject to post-payment review) (see also – TPL waivers).Effective July 2015, ADES/AzEIP and AHCCCS aligned their contracts and policy language to provide children and their families the opportunity to receive IFSP services, determined medically-necessary by the health plan, through the ADES/AzEIP TBEIS provider, regardless of whether the ADES/AzEIP TBEIS provider has a contract with the child’s health plan.

  • If the services requested through the AHCCCS Health Plan have not been approved or denied prior to the planned start date for the early intervention service on the IFSP, the service may be billed to ADES/AzEIP until the approval or denial from the health plan is received.

Related to AHCCCS Health Plan

  • Health plan or "health benefit plan" means any policy,

  • Retiree Health Plan means an "employee welfare benefit plan" within the meaning of Section 3(1) of ERISA that provides benefits to individuals after termination of their employment, other than as required by Section 601 of ERISA.

  • Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.

  • HMO means health maintenance organization.

  • AHCCCS means the Arizona Health Care Cost Containment System.

  • State health plan means the employee and retiree insurance program provided for in Article 5, Chapter 11, Title 1.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with or employed by the health carrier.

  • Health Plans means any and all individual and family health and hospitalization insurance and/or self-insurance plans, medical reimbursement plans, prescription drug plans, dental plans and other health and/or wellness plans.

  • Basic health plan means the plan described under chapter

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • RHS means the Rural Housing Service of the U.S. Department of Agriculture or any successor.

  • HHSC means the administrative agency established under Chapter 531, Texas Government Code, or its designee.

  • CMS means the Centers for Medicare and Medicaid Services.

  • Flexi Plan means any individual indemnity hospital insurance plan under the VHIS framework with enhancement(s) to any or all of the protections or terms and benefits that the Standard Plan provides to the Policy Holder and the Insured Person, subject to certification by the Government. Such plan shall not contain terms and benefits which are less favourable than those in the Standard Plan, save for the exception as may be approved by the Government from time to time.

  • HCFA means the United States Health Care Financing Administration and any successor thereto.

  • Home health aide means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.

  • Health practitioner means a registered health practitioner registered or licensed as a health practitioner under an appropriate law of the State of Tasmania.

  • Community mental health program means all mental health

  • UConn Health or “UCH” shall mean University of Connecticut Health and its affiliates.

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Health plan issuer means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the superintendent of insurance, that contracts, or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefit plan, including a sickness and accident insurance company, a health insuring corporation, a fraternal benefit society, a self-funded multiple employer welfare arrangement, or a nonfederal, government health plan. “Health plan issuer” includes a third party administrator to the extent that the benefits that such an entity is contracted to administer under a health benefit plan are subject to the insurance laws and rules of this state or subject to the jurisdiction of the superintendent. The “Health plan issuer” is also called the Administrator in this Benefit Booklet.

  • MHSA means the law that provides funding for expanded community Mental Health 22 Services. It is also known as “Proposition 63.”

  • Participating Prescription Drug Provider means an independent retail Pharmacy, chain of retail Pharmacies, mail-order Pharmacy or specialty drug Pharmacy which has entered into an agreement to provide pharmaceutical services to participants in the benefit program. A retail Participating Pharmacy may or may not be a select Participating Pharmacy as that term is used in the Vaccinations Obtained Through Participating Pharmacies section.

  • Participating Clinical Social Worker means a Clinical Social Worker who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.