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Capitated payment definition

Capitated payment means a monthly payment to the contractor on behalf of each enrollee for the provision of health services under the contract. Payment is made regardless of whether the enrollee receives services during the month.
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Capitated payment means the monthly payment paid to the PACE organization by ODJFSODM for medical care and services provided to medicaid recipients enrolled in the PACE program.
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Capitated payment means a fixed monthly payment paid per person by the department to a participating health plan for which the health plan provides a defined set of benefits.
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Examples of Capitated payment in a sentence

  • Capitated payment also reduces the incentive for providers to provide care outside normal care delivery hours.

  • 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.

  • For teacher salary placement, the individual shall be given prior experience credit pursuant to Article VI.

  • Capitated payment contracts essentially allocate a certain dollar amount per month for each patient that is assigned to the provider.28 The dollar amount that is allocated per patient of course is negotiated anew for each contract.

  • Capitated payment" means the monthly payment paid to the program of all inclusive care for the elderly PACE organization by the Ohio department of medicaid (ODM) for medical care and services provided to medicaid recipients enrolled in the PACE.

  • Capitated payment rates are central to improving the cost-effectiveness of services within a managed care environment because they allow the managing entity, the managed care organization or “MCO” wide latitude in utilizing available dollars to design interventions that both save money and improve outcomes.

  • Capitated payment is also cited by The Kings Fund as a viable way to commission MCPs.15 Capitated payments are an arrangement where a provider (or group of providers) is paid to deliver care to a target population across all of the different care settings that they might need.

  • COB amount An amount paid through coordination of benefits Capitated payment flag (is this an information- only claim submitted by a provider who receives a capitated payment) CAPITATION GROUP INDICATOR CODE is a Yes / No code used to identify a paid claim for a group with a capitated arrangement Prepaid amount For capitated services, the fee for service equivalent amount.

  • Capitated payment for PCP services retrospectively adjusted based on acuity2.

  • The Capitation Rate Methodology reflects CMS requirements that full-risk Capitated payment rates to CMOs be actuarially sound.


More Definitions of Capitated payment

Capitated payment means a fixed monthly payment paid per person by the department to a participating health plan for which the health plan provides a defined set of benefits and the payment may be prorated for the portion of the month for which the person was enrolled with the health plan.
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Capitated payment or “Capitation Payment” means a monthly prepayment to Contractor for the provision of Capitated Services provided on behalf of Members. Capitation Payment is made on a per Member, per month basis.
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Capitated payment or “Capitation Payment” means a monthly prepayment to Contractor for the provision of Capitated Services provided on behalf of Members. Capitation Payment is made on a per Member, per month basis. Capitation Payment does not include any payment made to a Fully Capitated Health Plan as a supplemental incentive payment under a Physician Access Improvement Plan Demonstration Project.
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Capitated payment means the monthly payment paid to the program of all inclusive care for the elderly PACE organization by the Ohio department of medicaid (ODM) for medical care and services provided to medicaid recipients enrolled in PACE.
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Related to Capitated payment

  • Permitted Payment as defined in Subsection 8.2(b).

  • Permitted Payments has the meaning specified in Section 7.06(b).

  • Insured Payment means (a) as of any Distribution Date, any Deficiency Amount and (b) any Preference Amount.

  • Deferred Payment means any severance pay or benefits to be paid or provided to Executive (or Executive’s estate or beneficiaries) pursuant to this Agreement and any other severance payments or separation benefits, that in each case, when considered together, are considered deferred compensation under Section 409A.

  • Defaulted Payment has the meaning specified in the definition of “Defaulting Lender”.

  • Insured Payments means, with respect to any Distribution Date, the aggregate amount actually paid by the Certificate Insurer to the Trustee in respect of (i) Insured Amounts for a Distribution Date and (ii) Preference Amounts for any given Business Day.

  • Specified Payment means any Permitted Acquisition, Investment, loan, advance, incurrence of or payment with respect to Indebtedness or other transaction made subject to satisfaction of the Payment Conditions or any component thereof.

  • Restricted Payment means any dividend or other distribution (whether in cash, securities or other property) with respect to any Equity Interests in the Borrower or any Subsidiary, or any payment (whether in cash, securities or other property), including any sinking fund or similar deposit, on account of the purchase, redemption, retirement, acquisition, cancellation or termination of any such Equity Interests in the Borrower or any option, warrant or other right to acquire any such Equity Interests in the Borrower.

  • Reduced payment means a payment that is for less than the amount agreed upon in a subcontract in accordance with its terms and conditions, for supplies and services for which the Government has paid the prime contractor.

  • Permitted Payments to Parent means, without duplication as to amounts:

  • Required Payment shall have the meaning assigned such term in Section 4.04.

  • Guaranteed Payment for each Class of Notes and any Payment Date means the sum of (i) the related Guaranteed Principal Payment Amount plus (ii) the related Aggregate Investor Interest for the Payment Date.

  • Prohibited Payment means any bribe, rebate, payoff, influence payment, kickback or other payment or gift of money or anything of value (including meals or entertainment) to any officer, employee or ceremonial office holder of any government or instrumentality thereof, political party or supra-national organization (such as the United Nations), any political candidate, any royal family member or any other person who is connected or associated personally with any of the foregoing that is prohibited under any Law for the purpose of influencing any act or decision of such payee in his official capacity, inducing such payee to do or omit to do any act in violation of his lawful duty, securing any improper advantage or inducing such payee to use his influence with a government or instrumentality thereof to affect or influence any act or decision of such government or instrumentality.

  • Restricted Payments as defined in Section 7.6.

  • Deferred Payments means any severance pay or benefits to be paid or provided to Executive (or Executive’s estate or beneficiaries) pursuant to this Agreement and any other severance payments or separation benefits to be paid or provided to Executive (or Executive’s estate or beneficiaries), that in each case, when considered together, are considered deferred compensation under Section 409A.

  • Required Payments means each of the items described in (i) through (xii) of Section 3.4 of the Indenture.

  • Index Related Payment Date means, in relation to any Index and an Index Determination Date, any payment date under the Preference Shares for which the amount payable is calculated by reference to the Index as determined on such Index Determination Date;

  • Restricted Payment Transaction means any Restricted Payment permitted pursuant to Section 409, any Permitted Payment, any Permitted Investment, or any transaction specifically excluded from the definition of the term “Restricted Payment” (including pursuant to the exception contained in clause (i) and the parenthetical exclusions contained in clauses (ii) and (iii) of such definition).

  • Required Payment Amount shall have, for any Distribution Date, the meaning specified for such Distribution Date in Section 4.6(a) of the Sale and Servicing Agreement.

  • Excepted Payments means and include (i)(A) any right, title or interest to any indemnity (whether or not constituting Supplemental Rent and whether or not a Lease Event of Default exists) payable to either the Owner Lessor, the Lessor Manager, the Trust Company, or the Owner Participant or to their respective Indemnitees and successors and permitted assigns (other than the Indenture Trustee) pursuant to Section 2.3, 9.1, 9.2, 11.1 or 11.2 of the Participation Agreement, and any payments under any Tax Indemnity Agreement (provided that Excepted Payments shall not include any Periodic Rent) or (B) any amount payable by the Facility Lessee to the Owner Lessor or the Owner Participant to reimburse any such Person for its costs and expenses in exercising its rights under the Operative Documents or the South Point Ground Lease, (ii)(A) insurance proceeds, if any, payable to the Owner Lessor or the Owner Participant under insurance separately maintained by the Owner Lessor or the Owner Participant with respect to the Facility as permitted by Section 3(b) of Schedule 5.31 to the Participation Agreement or (B) proceeds of personal injury or property damage liability insurance maintained under any Operative Document or the South Point Ground Lease for the benefit of the Owner Lessor or the Owner Participant, (iii) any amount payable to the Owner Participant as the purchase price of the Owner Participant's right and interest in the Member Interest, (iv) all other fees expressly payable to the Owner Participant under the Operative Documents, (v) any payments in respect of interest, or any payments made on an After-Tax Basis, to the extent attributable to payments referred to in clause (i) through (vi) above; (vii) any amounts paid to the Owner Lessor as reimbursement for amounts expended pursuant to Section 20 of the Facility Lease; (viii) proceeds of the items referred to in clause (i) through (vii) above; and (ix) any rights to demand, collect, sue for, or otherwise receive and enforce payment of the foregxxxg amounts, including under the Calpine Guaranty, but without limiting clause (v) of this definition above.

  • Scheduled Payment The scheduled monthly payment on a Mortgage Loan due on any Due Date allocable to principal and/or interest on such Mortgage Loan which, unless otherwise specified herein, shall give effect to any related Debt Service Reduction and any Deficient Valuation that affects the amount of the monthly payment due on such Mortgage Loan.

  • Excluded Payments means (i) indemnity payments paid or payable by Lessee to or in respect of Owner Participant, or Owner Trustee in its individual capacity, their respective Affiliates, successors and permitted assigns and their directors, officers, employees, servants and agents pursuant to Section 9 of the Participation Agreement or any corresponding payments under the Lease, (ii) proceeds of public liability insurance paid or payable as a result of insurance claims made, or losses suffered, by Owner Trustee in its individual capacity or by Owner Participant, that are payable directly to Owner Trustee in its individual capacity, or Owner Participant, respectively, for their own account, (iii) proceeds of insurance maintained with respect to the Aircraft by Owner Participant or any Affiliate thereof for its or their own account or benefit (whether directly or through Owner Trustee) and permitted under Section 11.2 of the Lease, (iv) all payments required to be made under the Tax Indemnity Agreement by Lessee whether or not denominated as Supplemental Rent, (v) any Transaction Expenses paid or payable by the Lessee to the Owner Trustee (to the extent for its sole benefit) or the Owner Participant pursuant to the Lease or the Participation Agreement, (vi) any amount payable to the Owner Participant by any transferee as the purchase price of the Owner Participant's interest in the Trust Estate, (vii) any interest that pursuant to the Operative Agreements may from time to time accrue in respect of any of the amounts described in clauses (i) through (vi) above, (viii) any right to enforce the payment of any amount described in clauses (i) through (vii) above (PROVIDED, that the rights referred to in this clause (viii) shall not be deemed to include the exercise of any remedies provided for in the Lease other than the right to xxx for specific performance of any covenant to make such payment or to xxx for damages in respect of the breach of any such covenant) and (ix) any right to exercise any election or option or make any decision or determination, or to give or receive any notice, consent, waiver or approval, or to take any other action in respect of, but in each case, only to the extent relating to, any Excluded Payments.

  • Deferred Payment Date for a Participant means the date after the Restricted Period in respect of Restricted Share Units which is the earlier of (i) the date which the Participant has elected to defer receipt of the underlying Shares in accordance with Section 4.5 of this Plan; and (ii) the Participant's Separation Date.

  • Designated Payment Office means the Office of NYSERDA’s Controller, located at 00 Xxxxxxxx Xxxxxx, Xxxxxx, Xxx Xxxx 00000.

  • Total Required Payment means, for a Payment Date, the sum of

  • Net Finance Charges means, for the Reference Period, the Finance Charges according to the latest Financial Report(s), after deducting any interest payable for that Reference Period to any member of the Group and any interest income relating to cash or cash equivalent investment.

Most Referenced Clauses

Most Referenced Definitions