Capitated contract definition

Capitated contract means a contract between the
Capitated contract means a contract between OHCA and a contracted entity for the delivery of services to Medicaid members in which OHCA pays a fixed, per-member per-month rate based on actuarial calculations.
Capitated contract. - This means contracts where eligibility is electronically provided by the payor, encounters are electronically processed, reimbursements are provided electronically, no charge entry is done by US Servis staff, at least 75% of the co-pays are collected and posted to the system by Client personnel, and capitation payments are posted to the system based upon a fixed, pre-agreed physician distribution formula.

Examples of Capitated contract in a sentence

  • The Contractor shall comply with Capitated contract rules established by PRICO, in accordance with Normative Letter CA-I-2-1232-91 (Attachment 13 to this Contract), which provides that every contract based on a Capitated payment arrangement prohibits the Provider from in turn subcontracting on a Capitated basis.

  • Capitated contract 1– In a capitated contract, the basis for payment is reported eligible enrollees.

  • Capitated contract provider: Individual DC receives monthly or annual payment adjusted for number of covered lives in contract providing all needed chiropractic services to plan members who present for care.


More Definitions of Capitated contract

Capitated contract means a contract in which an insurer pays directly or indirectly a fixed amount to a health care provider in exchange for the future rendering of medical services for covered expenses.

Related to Capitated contract

  • CFD Contract or "CFD" shall mean a contract which is a contract for difference by reference to fluctuations in the price of the relevant security or index;

  • Liquidated Contract means any defaulted Contract as to which the Servicer has determined that all amounts which it expects to recover from or on account of such Contract have been recovered; provided that any defaulted Contract in respect of which the related Manufactured Home and, in the case of Land-and-Home Contracts, Mortgaged Property, have been realized upon and disposed of and the proceeds of such disposition have been received shall be deemed to be a Liquidated Contract.

  • Related Contract means: (i) in relation to the SwapClear Service, a RelatedSwapClear Contract (as such term is defined in the Procedures); (ii) in relation to the RepoClear Service, a Related RepoClear Contract (as such term is defined in the Procedures); (iii) in relation to the ForexClear Service, a Related ForexClear Contract (as such term is defined in the Procedures); (iv) in relation to the EquityClear Service, a Related EquityClear Contract (as such term is defined in the Procedures); (v) in relation to the Listed Interest Rates Service, a Related Listed Interest Rates Contract (as such term is defined in the Procedures)"Relevant Auction Contract"has the meaning given to the term in the Client Clearing Annex"Relevant Business"has the meaning as described in Default Rule 15(c)"Relevant Client Clearing Business"means the Client Clearing Business conducted by a particular Clearing Member in a particular Service"Relevant Contract"has the meaning assigned to it in the Client Clearing Annex"Relevant Default"has the meaning ascribed to it in Rule S1 of Part A of the Rates Service Default Fund Supplement - SwapClear, Rule F2 of the ForexClear Default Fund Supplement or Rule R2 of the RepoClear Default Fund Supplement, as applicable"Relevant FX Amounts"means, in respect of a ForexClear Option Clearing Member and a day, all amounts that are due to be received by such ForexClear Option Clearing Member on such day under a ForexClear Option Contract, ForexClear Swap Contract, ForexClear Deliverable Forward Contract and/or ForexClear Spot Contract in any ForexClear Currency"Relevant FX Liability"has the meaning assigned to it in Regulation 101"re-opening contract"means a contract arising pursuant to Regulation 30(b) or 30(c)"RepoClear Additional Payments Cap"means, in respect of a RCM on any date, an amount equal to the Clearing Member Current Collateral Balance of that RCM in connection with its RepoClear Business as at the date of the Default causing losses leading to an Insufficient Resources Determination (or, where such an Insufficient Resources Determination is made following concurrent Defaults, the date of the earliest Default)"RepoClear Business"means any transaction, obligation or liability arising out of any Fixed Income Contract

  • Terminated Contracts has the meaning set forth in Section 5.6(a).

  • Covered contract means a DoD prime contract for an amount exceeding the simplified acquisition threshold, except for a fixed-price contract without cost incentives. The term also includes a subcontract for an amount exceeding the simplified acquisition threshold, except for a fixed-price subcontract without cost incentives under such a prime contract.

  • Provider contract means any contract between a provider and a carrier (or a carrier's network,

  • Prepaid contract means any Contract that has terminated or been prepaid in full prior to its scheduled expiration date (including because of a Casualty Loss), other than a Defaulted Contract.

  • Non-negotiated contract means a contract whose terms, other than the terms contained in point 11.C. (given below) are not negotiated between the parties to the financial contract and includes –

  • Service Contract means, with respect to a Financed Vehicle, the agreement, if any, financed under the related Receivable that provides for the repair of such Financed Vehicle.

  • Approved Contractor means an “Approved Contractor” specified in the Key Details.

  • Insured contract means any written: a. leases of premises; b. easement agreements, except those concerning construction or demolition operations abutting railroad property; c. obligation to insure a municipality as required by law or ordinance, except in connection with work for the municipality; d. sidetrack agreements; or e. elevator maintenance agreements.

  • The Contract means the agreement entered into between the Procuring Entity and the Supplier, as recorded in the Contract Form signed by the parties, including all attachments and appendices thereto and all documents incorporated by reference therein.

  • Service Subcontract means a subcontract primarily for the furnishing of services, to or for a recipient of Assistance, except where services are incidental to the delivery of products, equipment or commodities. A contract for the purchase or lease of goods, products, equipment, supplies or other property is not a “service subcontract” for the purposes of this definition.

  • Assigned Contract shall have the meaning set forth in Section 1.1(b).

  • Registered contract means a variable annuity contract or variable life insurance policy subject to the prospectus delivery requirements of the Securities Act of 1933.

  • Multiyear contract means a contract that extends beyond a one-year period, including a contract that permits renewal of the contract, without competition, beyond the first year of the contract.

  • works contract means a contract for building, construction, fabrication, completion, erection, installation, fitting out, improvement, modification, repair, maintenance, renovation, alteration or commissioning of any immovable property wherein transfer of property in goods (whether as goods or in some other form) is involved in the execution of such contract;

  • Customer Contract means a Contract (or group of related Contracts) pursuant to which any Group Company, after giving effect to the Pre-Closing Business Transfers, licenses or otherwise provides products and services to customers of the Business.

  • Tax Service Contract As defined in Section 3.09(a).

  • Master Contract means the CATS Master Contract between the Maryland Department of Budget and Management andTO Contractor dated December 19, 2005.

  • First-tier subcontract means a subcontract awarded directly by the Contractor for the purpose of acquiring supplies or services (including construction) for performance of a prime contract. It does not include the Contractor’s supplier agreements with vendors, such as long-term arrangements for materials or supplies that would benefit multiple contracts and/or the costs of which are normally applied to a Contractor’s general and administrative expenses or indirect cost.

  • Training Contract means an agreement signed by the employer and the Apprentice or Trainee (and a parent or guardian if applicable), in accordance with the Act and Regulatory requirements.

  • Standard Contract means a contract concerning a wholesale energy product admitted to trading at an organised market place, irrespective of whether or not the transaction actually takes place on that market place;

  • Master subcontracting plan means a subcontracting plan that contains all the required elements of an individual subcontracting plan, except goals, and may be incorporated into individual subcontracting plans, provided the master subcontracting plan has been approved.

  • Open Contract means a Contract which has not been closed out and which has not yet matured;

  • Contracted Services means covered services that are to be provided by the Contractor under the terms of this Contract.