Balance Xxxx definition

Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay.
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Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Capitation means the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made to the Contractor for the performance of all of the Contractor’s duties and obligations pursuant to this Contract.
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Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Behavioral Management Services means structured services designed to serve individuals with emotional, behavioral, and neurobiological or substance abuse problems of such severity that appropriate functioning in the home, school, or community requires highly structured behavioral intervention. Benefit Issuance Date means the monthly date that the eREP system determines eligibility and the Medicaid Managed Care System (MMCS) issues premiums to Health Plans.
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Examples of Balance Xxxx in a sentence

  • For Partially Allowed Claims that were reimbursed by the Company from August 20, 2011 to the Preliminary Approval Date, the Settlement Administrator will pay an amount equal to the lesser of (i) the Balance Xxxx outstanding for that Covered Service or Supply or (ii) 3% of the Allowed Amount for that Partially Allowed Claim.

  • Valid supporting documentation is limited to documentation from the Provider Class Member’s files (including records maintained for the benefit of the Provider Class Member by vendors or other professionals, including billing companies, Certified Public Accountants, and collection agencies), practice management system or accounting records showing that the Balance Xxxx remains unpaid.

  • For Partially Allowed Claims that were reimbursed by the Company from March 1, 2001 to August 19, 2011, the Settlement Administrator will pay an amount equal to the lesser of (i) the Balance Xxxx paid by the Subscriber Class Member for that Covered Service or Supply or (ii) 5% of the Allowed Amount for that Partially Allowed Claim.

  • If a Subscriber Class Member executed an Assignment for a Covered Service or Supply, or did not receive and pay a Balance Xxxx, that Subscriber Class Member may not request payment from the Subscriber Prove-Up Fund for the claim that is subject to such Assignment or for which no Balance Xxxx was received and paid.

  • For Partially Allowed Claims that were reimbursed by the Company from August 20, 2011 to the Preliminary Approval Date, the Settlement Administrator will pay an amount equal to the lesser of (i) the Balance Xxxx paid by the Subscriber Class Member or (ii) 3% of the Allowed Amount for that Partially Allowed Claim.

  • Claims eligible for payment from the Provider Prove-Up Funds are Partially Allowed Claims from June 3, 2003 to the Preliminary Approval Date, provided that the Provider Class Member had an executed Assignment for such Partially Allowed Claims and (ii) the Provider Class Member presented or sent to the Plan Member a Balance Xxxx, and received no payment, or less than full payment, for the Balance Xxxx.

  • Supporting documentation demonstrating that the Balance Xxxx was not paid in whole or in part.

  • In any event, the Member is responsible for any applicable Deductible, Copayment or Coinsurance amounts stated in the Schedule of Benefits and, unless the fee is negotiated, for any Balance Xxxx from a Non-Preferred Provider who is not a Hospital-Based Physician, an On-Call Physician, or an Ambulance Service Provider who accepts an Assignment of Benefits.

  • Supporting documentation that demonstrates a Balance Xxxx was presented to or sent to the Plan Member prior to the Preliminary Approval Date relating to the Partially Allowed Claim.

  • A gentle swab of the sample surface with a kimwipe paper resulted in easy removal of the deposits in all the borided samples as indicated in Figure 3.


More Definitions of Balance Xxxx

Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Behavioral Management Services means structured services designed to serve individuals with emotional, behavioral, and neurobiological or substance abuse problems of such severity that appropriate functioning in the home, school, or community requires highly structured behavioral intervention. BMHC means the Bureau of Managed Health Care, Division of Medicaid and Health Financing, Utah Department of Health. Capitation means the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made to the Contractor for the performance of all of the Contractor’s duties and obligations pursuant to this Contract.
Sample 1Sample 2Sample 3
Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Behavioral Management Services means structured services designed to serve individuals with emotional, behavioral, and neurobiological or substance use problems of such severity that appropriate functioning in the home, school, or community requires highly structured behavioral intervention. Benefit Issuance Date means the monthly date that the eREP system determines eligibility and the Medicaid Managed Care System (MMCS) issues premiums to Integrated Care Plans. Bureau of Managed Health Care (BMHC) means the entity within the Division of Medicaid and Health Financing, Utah Department of Health. Capitation means the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made to the Contractor for the performance of all of the Contractor’s duties and obligations pursuant to this Contract.
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Balance Xxxx means the practice of billing patients for charges that exceed the amount that the Contractor will pay. Behavioral Management Services means structured services designed to serve individuals with emotional, behavioral, and neurobiological or substance use problems of such severity that appropriate functioning in the home, school, or community requires highly structured behavioral intervention. Benefit Issuance Date means the monthly date that the eREP system determines eligibility and the Medicaid Managed Care System (MMCS) issues premiums to Health Plans. Bureau of Managed Health Care (BMHC) means the entity within the Division of Medicaid and Health Financing, Utah Department of Health. Capitation means the reimbursement arrangement in which a fixed rate of payment per Enrollee per month is made to the Contractor for the performance of all of the Contractor’s duties and obligations pursuant to this Contract, except for the Delivery Case Rate. Capitation Payment means the payment the Department makes periodically to the Contractor on behalf of each Enrollee for the provision of Covered Services under the Contract and based on the actuarially sound Capitation Rate. The Department makes the payment regardless of whether the particular Enrollee receives services during the period covered by the payment. Capitation Rate means the rate negotiated between the Contractor and Department for each Medicaid eligibility group or Capitation Rate Cell. In developing actuarially sound Capitation Rates, the Department will apply the elements required in 42 CFR 438.6(c). Centers for Medicare and Medicaid Services (CMS) means the federal agency within the Department of Health and Human Services that administers the Medicare and Medicaid programs, and works with states to administer the Medicaid program. CHEC or Child Health Evaluation and Care means Utah’s former version of the federally mandated Early Periodic Screening, Diagnosis and Treatment (EPSDT) program as defined in 42 CFR Part 441, Subpart B. The program is now referred to as EPSDT. Child with Special Health Care Needs means a child under 21 years of age who has or is at increased risk for chronic physical, developmental, behavioral, or emotional conditions and requires health and related services of a type or amount beyond that required by children
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Balance Xxxx means a written xxxx, invoice, or other demand for payment from a provider or provider’s representative seeking payment from a Plan Member for the difference between a provider’s billed charge and the Company’s Allowed Amount for a Covered Service or Supply. A Balance Xxxx does not include a xxxx for any other amounts, such as Denied Claims, co-insurance, deductibles, and coordination of benefits. Under this Agreement, a Balance Xxxx includes any written xxxx for this amount regardless of when or how it is presented to the Plan Member, including a xxxx for the entire billed charge that the provider presented to the Plan Member in person at the time of the Covered Service or Supply, as well as a xxxx that the provider sent to the Plan Member by mail or other means after reimbursement of the Allowed Amount for the Covered Service or Supply by Company.
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Balance Xxxx as used in this Claim Form means, as defined in the Settlement, a written xxxx, invoice, or other demand for payment from a Provider or Provider’s representative seeking payment from a Plan Member for the difference between a Provider’s billed charge and the Company’s Allowed Amount for a Covered Service or Supply. A Balance Xxxx does not include a xxxx for any other amounts, such as Denied Claims, co-insurance, deductibles, and coordination of benefits. A Balance Xxxx includes any written xxxx for this amount regardless of when or how it is presented to the Plan Member, including a xxxx for the entire billed charge that the provider presented to the Plan Member in person at the time of the Covered Service or Supply, as well as a xxxx that the Provider sent to the Plan Member by mail or other means after reimbursement of the Allowed Amount for the Covered Service or Supply by Company.
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Balance Xxxx as used in this Claim Form means, as defined in the Settlement, a written xxxx, invoice, or other demand for payment from a provider or provider’s representative seeking payment from a Plan Member for the difference between a provider’s billed charge and the Company’s Allowed Amount for a Covered Service or Supply. A Balance Xxxx does not include a xxxx for any other amounts, such as Denied Claims, co-insurance, deductibles, and coordination of benefits. Under this Agreement, a Balance Xxxx includes any written xxxx for this amount regardless of when or how it is presented to the Plan Member, including a xxxx for the entire billed charge that the provider presented to the Plan Member in person at the time of the Covered Service or Supply, as well as a xxxx that the provider sent to the Plan Member by mail or other means after reimbursement of the Allowed Amount for the Covered Service or Supply by Company. Must be Postmarked On or Before Xxxxxxxxx xx, 201x In re Aetna UCR Litigation Master Docket No. 07-3541(SRC)(PS)) U.S. District Court for the District of New Jersey For Official Use Only If you wish to submit a claim as a Provider Class Member under the Settlement, complete this form and mail it to the address below. Make sure to complete all required sections and sign the end of the claim form. For more information about this Settlement, please consult the Settlement Agreement and/or Settlement Notice (both of which are available in the Court’s file or at www. .com).
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Related to Balance Xxxx

  • Balance Amount shall have the meaning set forth in Section 8.1 of this Agreement.

  • Balance Due Date means the date shown below in Section 2.4(6) as the date when the Mortgage matures. On this date the Mortgage must be repaid or renewed.

  • PRE-2017 NET OPERATING LOSS CARRYFORWARD means any net operating loss incurred in a taxable year beginning before January 1, 2017, to the extent such loss was permitted, by a resolution or ordinance of the Municipality that was adopted by the Municipality before January 1, 2016, to be carried forward and utilized to offset income or net profit generated in such Municipality in future taxable years.(B) For the purpose of calculating municipal taxable income, any pre-2017 net operating loss carryforward may be carried forward to any taxable year, including taxable years beginning in 2017 or thereafter, for the number of taxable years provided in the resolution or ordinance or until fully utilized, whichever is earlier.

  • Unpaid Realized Loss Amount With respect to any Class of Subordinated Certificates and as to any Distribution Date, is the excess of (i) the Applied Realized Loss Amounts with respect to such Class over (ii) the sum of (a) all distributions in reduction of such Applied Realized Loss Amounts on all previous Distribution Dates, and (b) the amount by which the Class Certificate Balance of such Class has been increased due to the distribution of any Subsequent Recoveries on all previous Distribution Dates. Any amounts distributed to a Class of Subordinated Certificates in respect of any Unpaid Realized Loss Amount will not be applied to reduce the Class Certificate Balance of such Class.

  • Balance means the total financial result of all Completed Transactions and depositing/withdrawal operations on the Trading Account.

  • SF1-4 Intrinsic Loss Estimate means total losses under this Single Family Shared-Loss Agreement in the amount of eighteen million dollars ($18,000,000.00).

  • Balance billing means charging or collecting an amount in excess of the Medicaid, Medicare, or contracted reimbursement rate for services covered under a Medicaid, Medicare or employer sponsored beneficiary’s plan. “Balance Billing” does not include charging or collecting deductibles or copayments and coinsurance required by the beneficiary’s plan.

  • Allocated Realized Loss Amount With respect to any Distribution Date and any Class of Mezzanine Certificates, the sum of (i) any Realized Losses allocated to such Class of Certificates on such Distribution Date and (ii) the amount of any Allocated Realized Loss Amount for such Class of Certificates remaining unpaid from the previous Distribution Date.

  • Vapor balance system means a combination of pipes or hoses which create a closed system between the vapor spaces of an unloading tank and a receiving tank such that vapors displaced from the receiving tank are transferred to the tank being unloaded.

  • Diameter at Breast Height (DBH) means the diameter of a tree at 4 1/2 feet above the ground measured from the uphill side.

  • Balance Date means 30 June or any other date that the Trustees by resolution adopt as the date up to which the Trust’s financial statements are to be made in each year;

  • Monthly Loss Amount means the sum of all Foreclosure Losses, Restructuring Losses, Short Sale Losses, Portfolio Losses, Modification Default Losses and Deficient Losses realized by the Assuming Institution for any Shared Loss Month.

  • Class C Unpaid Realized Loss Amount As of any Distribution Date, the excess of (1) the Class C Applied Realized Loss Amount over (2) the sum of (x) all distributions in reduction of the Class C Unpaid Realized Loss Amounts on all previous Distribution Dates and (y) all increases in the Certificate Principal Balance of such Class C Certificates pursuant to the last sentence of the definition of "Certificate Principal Balance."

  • Monthly Shared-Loss Amount means the change in the Cumulative Shared- Loss Amount from the beginning of each month to the end of each month.

  • Shared-Loss Amount has the meaning provided in Section 2.1(b)(i) of this Commercial Shared-Loss Agreement.

  • Net Loss Amount means the sum of Cumulative Loss Amounts under this Single Family Shared-Loss Agreement and Aggregate Net Charge-Offs under the Commercial Shared-Loss Agreement.

  • Balance bill means a bill sent to an enrollee by ((an out-

  • Fraud Loss Amount As of any date of determination after the Cut-off Date, an amount equal to: (X) prior to the first anniversary of the Cut-off Date an amount equal to 3.00% of the aggregate outstanding principal balance of all of the Mortgage Loans as of the Cut-off Date minus the aggregate amount of Fraud Losses allocated solely to one or more specific Classes of Certificates in accordance with Section 4.05 of this Series Supplement since the Cut-off Date up to such date of determination, (Y) from the first to, but not including, the second anniversary of the Cut-off Date, an amount equal to (1) the lesser of (a) the Fraud Loss Amount as of the most recent anniversary of the Cut-off Date and (b) 2.00% of the aggregate outstanding principal balance of all of the Mortgage Loans as of the most recent anniversary of the Cut-off Date minus (2) the aggregate amount of Fraud Losses allocated solely to one or more specific Classes of Certificates in accordance with Section 4.05 since the most recent anniversary of the Cut-off Date up to such date of determination, and (Z) from the second to, but not including, the fifth anniversary of the Cut-off Date, an amount equal to (1) the lesser of (a) the Fraud Loss Amount as of the most recent anniversary of the Cut-off Date and (b) 1.00% of the aggregate outstanding principal balance of all of the Mortgage Loans as of the most recent anniversary of the Cut-off Date minus (2) the aggregate amount of Fraud Losses allocated solely to one or more specific Classes of Certificates in accordance with Section 4.05 since the most recent anniversary of the Cut-off Date up to such date of determination. On and after the fifth anniversary of the Cut-off Date, the Fraud Loss Amount shall be zero. The Fraud Loss Amount may be further reduced by the Master Servicer (including accelerating the manner in which such coverage is reduced) provided that prior to any such reduction, the Master Servicer shall (i) obtain written confirmation from each Rating Agency that such reduction shall not reduce the rating assigned to any Class of Certificates by such Rating Agency below the lower of the then-current rating or the rating assigned to such Certificates as of the Closing Date by such Rating Agency and (ii) provide a copy of such written confirmation to the Trustee.

  • Loss Amount means the dollar amount of loss incurred and reported on the Monthly Certificate for a Shared-Loss Loan.

  • Cumulative Loss Amount means the sum of the Monthly Loss Amounts less the sum of all Recovery Amounts.

  • Total Intrinsic Loss Estimate means the sum of the SF1-4 Intrinsic Loss Estimate in the Single Family Shared-Loss Agreement, and the Commercial Intrinsic Loss Estimate in the Commercial Shared-Loss Agreement, expressed in dollars.

  • Group II Interest Remittance Amount With respect to any Distribution Date, that portion of the Available Funds for such Distribution Date attributable to interest received or advanced with respect to the Group II Mortgage Loans.

  • REMIC 2 Interest Loss Allocation Amount With respect to any Distribution Date, an amount equal to (a) the product of (i) the aggregate Stated Principal Balance of the Mortgage Loans and related REO Properties then outstanding and (ii) the Uncertificated REMIC 2 Pass-Through Rate for REMIC 2 Regular Interest LTAA minus the Marker Rate, divided by (b) 12.

  • Planned Balance Not applicable.

  • Applied Loss Amount With respect to any Distribution Date, the amount, if any, by which (x) the aggregate Certificate Principal Amount of the Certificates after giving effect to all Realized Losses incurred with respect to the Mortgage Loans during the related Collection Period and distributions of principal on such Distribution Date, but before giving effect to any application of the Applied Loss Amount with respect to such date, exceeds (y) the Pool Balance for such Distribution Date.

  • REMIC 2 Principal Loss Allocation Amount With respect to any Distribution Date and the mortgage loans, an amount equal to (a) the product of (i) the Aggregate Stated Principal Balance of the Mortgage Loans and related REO Properties then outstanding and (ii) 1 minus a fraction, the numerator of which is two times the aggregate of the Uncertificated Principal Balances of REMIC 2 Regular Interest A-1, REMIC 2 Regular Interest A-1M, REMIC 2 Regular Interest A-1W, REMIC 2 Regular Interest A-2A, REMIC 2 Regular Interest A-2B, REMIC 2 Regular Interest A-2C, REMIC 2 Regular Interest A-2D, REMIC 2 Regular Interest M-1, REMIC 2 Regular Interest M-2, REMIC 2 Regular Interest M-3, REMIC 2 Regular Interest M-4, REMIC 2 Regular Interest M-5, REMIC 2 Regular Interest M-6, REMIC 2 Regular Interest M-7, REMIC 2 Regular Interest M-8 and REMIC 2 Regular Interest B, and the denominator of which is the aggregate of the Uncertificated Principal Balances of REMIC 2 Regular Interest A-1, REMIC 2 Regular Interest A-1M, REMIC 2 Regular Interest A-1W, REMIC 2 Regular Interest A-2A, REMIC 2 Regular Interest A-2B, REMIC 2 Regular Interest A-2C, REMIC 2 Regular Interest A-2D, REMIC 2 Regular Interest M-1, REMIC 2 Regular Interest M-2, REMIC 2 Regular Interest M-3, REMIC 2 Regular Interest M-4, REMIC 2 Regular Interest M-5, REMIC 2 Regular Interest M-6, REMIC 2 Regular Interest M-7, REMIC 2 Regular Interest M-8, REMIC 2 Regular Interest B and REMIC 2 Regular Interest ZZ.