Base Capitation Rate definition

Base Capitation Rate a fixed monthly fee paid prospectively by EOHHS to the Contractor for each Enrollee for all Covered Services actually and properly delivered to the Enrollees in accordance with and subject to the provisions of this Contract and all applicable federal and state laws, regulations, rules, billing instructions, and bulletins, as amended, prior to the application of any risk adjustment.”
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Examples of Base Capitation Rate in a sentence

  • The Base Capitation Rate shall be comprised of a Medical Component and Administrative Component.

  • If Base Capitation Rates are not risk adjusted, the Base Capitation Rate is the Risk Adjusted Rate.

  • The Department will multiply the Base Capitation Rate by a RAR MCO Plan Factor, as provided to the PH-MCO, to compute a Risk Adjusted Rate.

  • The Base Capitation Rate shall be *** per Commercial Plan Member per month for Nuestra Familia (PacifiCare Dec # 11315).

  • The Base Capitation Rate for both Gateway Physicians-United Western Medical Center (DEC 16210) and Gateway Physicians-Placentia ▇▇▇▇▇ (DEC 16206) shall be *** per Commercial Plan Member per month.

  • Specifically, this includes the portion of the rate that is calculated by subtracting the LTSS portion of the rate from the NHC Base Capitation Rate for each rating category, including the medical expenses not related to LTSS services and all non-medical expenses.

  • The Base Capitation Rate shall be *** per Commercial Plan Member per month for Prospect Central (PacifiCare Dec # 11276).

  • The Base Capitation Rate shall be *** per Commercial Plan Member per month for Prospect North (PacifiCare Dec # 3948).

  • The Base Capitation Rate shall be *** per Commercial Plan Member per month for Prospect South (PacifiCare Dec # 11277).

  • The Base Capitation Rate shall be *** per Commercial Plan Member per month.

Related to Base Capitation Rate

  • Capitation rate means the fee the department pays monthly to an HMO for each enrolled recipient for the provision of covered medical and health services whether or not the enrolled recipient received services during the month for which the fee is intended.

  • Base CD Rate means the sum of (a) the Three-Month Secondary CD Rate multiplied by the Statutory Reserve Rate plus (b) the Assessment Rate.

  • Inflation rate means that term as defined in section 34d.

  • Calculation Rate For each Distribution Date, in the case of the Class A and Class B Interests, the product of (i) 10 and (ii) the weighted average rate of the outstanding Class A and Class B Interests, treating each Class A Interest as capped at zero or reduced by a fixed percentage of 100% of the interest accruing on such Class.

  • HICP Daily Inflation Reference Index means (A) in relation to the first day of any given month, the HICP Monthly Reference Index of the third month preceding such month, and (B) in relation to a day (D) (other than the first day) in any given month (M), the linear interpolation of the HICP Monthly Reference Index pertaining respectively to the third month preceding such month (M - 3) and the second month preceding such month (M - 2) calculated in accordance with the following formula: