Capitation Services definition

Capitation Services means all CALIFORNIACARE Covered Medical Services which are not otherwise defined in this Agreement or in the Division of Financial Responsibilities (Exhibit A-1 hereto) as Non-Capitated Services.
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Capitation Services means those services listed in Section 2.1 of this Agreement, including in lieu of services, for which the Contractor receives a Capitation Payment from the Department.
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Capitation Services means all BLUE CROSS SENIOR SECURE Covered Medical Services which are not otherwise defined in this Agreement or in the Division of Financial Responsibilities (Exhibit A(1) hereto) as Non-Capitated Services, or MEDICARE BLUE USA Away From Home Care Services.
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Examples of Capitation Services in a sentence

  • To accept the monthly Capitation payment from BLUE CROSS as payment in full for Capitation Services (including all Referral Services) provided or arranged hereunder, and not to seek additional payments or compensation from Members for Covered Medical Services.

  • This limitation shall not prevent BLUE CROSS from initiating such procedures as the representative of its Members, or PARTICIPATING MEDICAL GROUP from initiating such procedures on behalf of Members for whom they have assumed responsibility for the provision of Capitation Services, and for arranging Non-Capitated Services provided that in any such case BLUE CROSS or PARTICIPATING MEDICAL GROUP, respectively, shall be considered the initiating party for the purposes of Section 14.03 hereof.

  • PARTICIPATING MEDICAL GROUP shall be solely responsible to the Member for treatment and medical care with respect to the provision of Capitation Services and arrangements for Non-Capitated Services.

  • To promptly provide, arrange through referral, or authorize all Capitation Services, and to authorize or arrange for the provision of all Non-Capitated Services, and further, to accept full financial responsibility for all Capitation Services provided, authorized or arranged through referral, by PARTICIPATING MEDICAL GROUP in accordance with the provisions of this Agreement.

  • A complete listing of Members that are eligible for Capitation Services is provided in the monthly Eligibility Report, as set forth in Article VI.

  • To use a referral request process by which Capitation Services are to be rendered by Health Professionals other than the Member’s Primary Care Physician, including PARTICIPATING MEDICAL GROUP Physicians or other Health Professionals who do not belong to PARTICIPATING MEDICAL GROUP.

  • All co-payments applicable to Capitation Services rendered to Members shall be subtracted from Capitation Services expenses.

  • The numbers and types (in terms of training, experience, and specialization) of Network Providers required to furnish Capitation Services and other Covered Services in a timely manner.

  • The Contractor must maintain a Network sufficient to provide prompt access to Capitation Services and Covered Services that are not required to be delivered directly by the Contractor, including LTSS that are not provided in the Provider’s office.

  • The Department will pay only the Contractor for Capitation Services, except when payment is specifically provided for in Title XIX of the Social Security Act, in 42 CFR Chapter IV, or when the Department has adjusted the Capitation Rate paid under the contract for graduate medical education.


More Definitions of Capitation Services

Capitation Services means all AIM Covered Medical Services which are not otherwise designated as Insured Services or the responsibility of BLUE CROSS, in the Division of Financial Responsibilities under Exhibit A(1).
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Capitation Services means all CALIFORNIAKIDS Covered Medical Services which are not otherwise defined or otherwise designated as the responsibility of BLUE CROSS in the Division of Medical Responsibilities (Exhibit A hereto).
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Related to Capitation Services

  • Education Services means training services performed or delivered by Company.

  • Hosting Services means the provision, administration, and maintenance of servers and related equipment, the provision of bandwidth at the hosting facility, and the operation of the Application for access by Customer Users to be provided by the relevant hosting service provider.

  • Collection Services means all of the duties and obligations of the Contractor hereunder.

  • Implementation Services has the meaning set forth in Section 2.1.

  • Interconnection Service(s) means any Interconnection, Resale Services, 251(c)(3) UNEs, Collocation, functions, facilities, products or services offered under this Agreement.

  • Hospice services means palliative and supportive care and other services provided by an interdisciplinary team under the direction of an identifiable hospice administration to terminally ill hospice patients and their families to meet the physical, nutritional, emotional, social, spiritual, and special needs experienced during the final stages of illness, dying, and bereavement, as defined in Minnesota Statutes, § 144A.75, subd. 8, and includes the set of services as determined by the Medicare program under §1861(dd) of the Social Security Act and defined in 42 CFR § 418.3.

  • Generation Service means the sale of electricity, including ancillary services such as the provision of reserves, to a Customer by a Competitive Supplier.

  • Standard fertility preservation services means procedure based upon current evidence-based standards of care established by the American Society for Reproductive Medicine, the American Society for Clinical Oncology, or other national medical associations that follow current evidence-based standards of care.

  • Support Services means support in relation to the use of, and the identification and resolution of errors in, the Hosted Services, but shall not include the provision of training services;

  • Application Services means the hosted applications and related services as described in Exhibit A.

  • Nursing services means the provision of individual-specific advice, plans, or interventions by a nurse at a home based on the nursing process as outlined by the Oregon State Board of Nursing. Nursing services differ from administrative nursing services.

  • Transportation Services means travel assistance given to an individual

  • Information Services means the Municipal Securities Rulemaking Board’s Electronic Municipal Market Access System; or, such other services providing information with respect to called municipal obligations as the District may specify in writing to the Paying Agent or as the Paying Agent may select.

  • Construction Services means either of the following for construction-manager-at-risk, design-build and job-order-contracting project delivery methods:

  • Distribution Services means the service of distribution, as defined in section 5 of the Act;

  • Administration Services means the services required for the effective and efficient administration of Bonitas and includes, but are not necessarily limited to, member record management, contribution management, benefit option management, claims processing and management, management of members’ personal, claims and financial information and any other services that are required for the administration of Bonitas;

  • Contract Services means the Services to be supplied by the Supplier to the Customer as set out in the Letter of Appointment;

  • Broadband Services means Verizon's Fios or DSL-based Internet services (whichever applies). Verizon's DSL-based Internet service is also known as "High Speed Internet" ("HSI").

  • Basic generation service or "BGS" means electric generation

  • Electric generation service means the provision of retail

  • Extra Services means those services set forth in Schedule “B” that are requested by the Municipality for itself or on behalf of its citizens and provided by the Company in accordance with paragraph 7 of this Agreement;

  • Transition Services means a coordinated set of activities for a child with a disability that:

  • Basic generation service provider or "provider" means a

  • Installation Services means all those services ancillary to the supply of the Plant and Equipment for the Facilities, to be provided by the Contractor under the Contract; e.g., transportation and provision of marine or other similar insurance, inspection, expediting, site preparation works (including the provision and use of Contractor’s Equipment and the supply of all construction materials required), installation, testing, pre-commissioning, commissioning, operations, maintenance, the provision of operations and maintenance manuals, training, etc.

  • Child support services means any civil, criminal or administrative action taken by the Division of

  • Pharmacy services means the practice of pharmacy as defined in chapter 18.64 RCW and includes any drugs or devices as defined in chapter 18.64 RCW.