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Contracted rate definition

Contracted rate means the totalamount (including cost sharing) that a group health plan or health insurance issuer has contractually agreed to pay a participating provider, facility, or provider of air ambulance services for covered items and services, whether directly or indirectly, including through a third-party administrator or pharmacy benefit manager. Solely for purposes ofthis definition, a single case agreement, letter of agreement, or other similar arrangement between a provider, facility, or air ambulance provider and a plan or issuer, used to supplement the network of the plan or coverage for a specific participant or beneficiary in unique circumstances, does not constitute a contract.
Contracted rate means the fee or reimbursement amount for a network provider ’s services, treatments, or supplies as established by agreement between the provider and health benefit plan issuer.
Contracted rate is defined in Section 3.2.5.

Examples of Contracted rate in a sentence

  • In such an event, the Contractor will receive a written notice* of approval from the Agency’s Program Manager or designee.When overtime is approved, the Contractor must compensate the temporary staff employee at a rate of 1½ times the Contracted rate, when the temporary staff employee completes more than 40- hours in one-week.Please Note: The State will not pay overtime that has not been previously approved/Authorized by the requesting Areas Program Manager.

  • In such an event, the Contractor will receive a written notice* of approval from the Agency’s Program Manager or designee.When overtime is approved, the Contractor must compensate the Temporary Staff Employee at a rate of 1½ times the Contracted rate, when the Temporary Staff Employee completed more than 40-hours in one-week.Please Note: The State will not pay overtime that has not been previously approved/authorized by the requesting Agency’s Program Manager or designee.

  • Contracted rate is defined as the rate percentage for reimbursement above the Medicare/Medicaid rates that would apply.

  • The Contracted rate will vary with variation in the increase/decrease in the Basic Price of ‘’RAMAPET N1” grade of Pet Resin according to the below mentioned formula.

  • Annual golf passes are recognized as revenue in the applicable membership period which is based on the fiscal year.


More Definitions of Contracted rate

Contracted rate means the fee or reimbursement
Contracted rate means the rate negotiated by nib/IMAN with Private Hospitals which have agreements with us. There will be minimum out-of-pocket expenses for customers attending nib/IMAN agreement Private Hospitals.
Contracted rate appearing in the Definitions section of the Prescription Drug Rider is hereby deleted and, all references to “Contracted Rate” are replaced by “Negotiated Charge” and the following definition is added to the Definitions section of the Prescription Drug Rider: • Negotiated Charge. The compensation amount negotiated between HMO or an affiliate and a Participating Retail Pharmacy, Participating Mail Order Pharmacy, or Specialty Pharmacy Network pharmacy for Medically Necessary outpatient prescription drugs and insulin dispensed to a Member and covered under the Member’s benefit plan. This negotiated compensation amount does not reflect or include any amount HMO or an affiliate may receive under a rebate arrangement between HMO or an affiliate and a drug manufacturer for any drug, including drugs on the Drug Formulary. The Definitions section of the Prescription Plan Rider is amended to add the following: • Self-injectable Drug(s). Prescription drugs that are intended to be self administered by injection to a specific part of the body to treat certain chronic medical conditions. An updated copy of the list of covered Self-injectable Drugs, designated by HMO as eligible for coverage under this amendment, shall be available upon request by the Member or may be accessed at the HMO website, at xxx.xxxxx.xxx. The list is subject to change by HMO or an affiliate. • Specialty Pharmacy Network. A network of Participating pharmacies designated to fill Self-injectable Drugs prescriptions. The Additional Benefits section of the Prescription Plan Rider is amended to include the following benefits: Self-injectable Drugs, eligible for coverage under this amendment, are covered when prescribed by a Provider licensed to prescribe federal legend prescription drugs or medicines. The initial prescription must be filled at a Participating Retail Pharmacy, Participating Mail Order Pharmacy or Specialty Pharmacy Network pharmacy. All refills must be filled by a Specialty Pharmacy Network pharmacy. Coverage of Self-injectable Drugs may, in HMO’s sole discretion, be subject to the Precertification Program, the Step Therapy Program or other HMO requirements or limitations. Food and Drug Administration (FDA) approved Self-injectable Drugs, eligible for coverage under this amendment, are covered when the off-label use of the drug has not been approved by the FDA for that indication, provided that such drug is recognized for treatment of such indication in one of the standard reference c...
Contracted rate means the amount the Provider has agreed to accept as payment under the Provider’s contract with a third party network vendor.
Contracted rate means the contracted and/or agreed upon reimbursement rate between Walgreens and the applicable Private Insurer and includes any Taxes, Eligible Patient co-pay, or other amounts that may be due from an Eligible Patient or Private Insurer or arise out of the coordination of benefits, as applicable. The Contracted Rate is Walgreen’s proprietary and confidential information; therefore, Covered Entity acknowledges and agrees that it will not request, and Walgreens will not provide, the Contracted Rate or any information which may disclose or enable the Covered Entity to determine the Contracted Rate.
Contracted rate means the amount the Provider has agreed to accept as payment under the Provider’s contract with a third-party network vendor.
Contracted rate means the contracted and/or agreed upon reimbursement rate between Walgreens and the applicable Private Insurer and includes any Taxes, Eligible Patient co-pay, or other amounts that may be due from an Eligible Patient or Private Insurer or arise out of the coordination of 10/12/2022 Original (e) sent to X. Xxxxxx, X. Xxxx, X. Xxxxxxx, Purchasing dept. benefits, as applicable. The Contracted Rate is Walgreen’s proprietary and confidential information; therefore, Covered Entity acknowledges and agrees that it will not request, and Walgreens will not provide, the Contracted Rate or any information which may disclose or enable the Covered Entity to determine the Contracted Rate.