Capitated Services definition

Capitated Services means those covered services that a PHP agrees to provide for a capitation payment under contract with the Authority.

Capitated Services means those covered services that an MCE agrees to provide for a capitation payment under contract with the Authority.

Capitated Services means services rendered by a provider through a contract in which payments are based upon a fixed monthly dollar amount for each enrollee.

Examples of Capitated Services in a sentence

• In the event that PPG does not process and pay eligible claims submitted to PPG for Capitated Services within applicable time limits, HMO may pay such claims at the lesser of HMO’s contract rate with such provider, if any, PPG’s subcontract terms, or provider’s billed charges.

• PPG Capitated Services and Shared Risk Services provided or arranged through PPG.

• PPG shall compensate all providers who render PPG Capitated Services to Commercial HMO and Commercial POS Members assigned to PPG.

• PPG and Member Physicians shall render Contracted Services which are not PPG Capitated Services to Members covered under this Addendum B and shall be compensated on a fee-for-service basis at the rates set forth in Addendum E.

• PPG shall compensate all providers of PPG Capitated Services to Medicare HMO Members assigned to PPG.

More Definitions of Capitated Services

Capitated Services means services paid through a fixed amount of money per patient per unit of time paid in advance for the delivery of health care services. The actual amount of money paid is determined by the ranges of services that are provided, the number of patients involved, and the period of time during which the services are provided.

Capitated Services means services rendered by a provider through a contract in which payment are based upon a fixed dollar amount for each member on a monthly basis.

Capitated Services means those Covered Services which are provided or arranged by Participating Providers in exchange for a fixed monthly payment per Enrollee.

Capitated Services means those Covered Services that Contractor agrees to provide in the Statement of Work, Exhibit B, Part I through VI of this Contract, in exchange for a Capitation Payment.

Capitated Services means Contract Services for which (PACE Program) receives a capitated payment.

Capitated Services means those covered services that an MCE agrees to provide for a capitation

Capitated Services means services rendered by a provider through a contract in which payments are based upon a fixed dollar amount for each member on a monthly basis.