Coordinated Care definition

Coordinated Care means the management of health care services by a third-party payer for a beneficiary. Examples include, but are not limited to, provider selection or referral, preadmission certification, length of stay determination and second surgical opinions.
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Coordinated Care means services directly related to covered school-based health services (SBHS) specified in the individualized education program (IEP) or individualized family service plan (IFSP), performed by medically qualified staff, and allowed under OAR 410-133-0080 Coverage to manage integration of those health services in an education setting. Coordinated care includes the following activities:
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Coordinated Care. Is the service provided to enrollees by doctors who are part of the preferred network of providers Primary Medical Group. The Primary Care physician is the leading provider of services for he is responsible to periodically evaluate their health and coordinate all medical services they need. Coordination of benefits: The order in which health services are paid when the person has more than one medical plan. One of the plans is considered the primary plan and the other the secondary plan or secondary payer.
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Examples of Coordinated Care in a sentence

  • The ACO shall not, and shall ensure that its Next Generation Participants, Preferred Providers, and any other individuals or entities performing services related to ACO Activities do not, provide gifts or other remuneration to Next Generation Beneficiaries as inducements for receiving the Coordinated Care Reward or to influence a Next Generation Beneficiary’s decision to qualify for the Coordinated Care Reward.

  • In any Performance Year in which CMS elects to make Coordinated Care Reward payments, the ACO shall ensure that all Next Generation Beneficiaries will be directed by the ACO, Next Generation Participants, Preferred Providers, and other individuals or entities performing functions or services related to ACO Activities to 1-800-MEDICARE to obtain additional information about the Coordinated Care Reward.

  • A description of all available Coordinated Care covered services, including EPSDT and other preventive services, and an explanation of any service limitations, referral and prior authorization requirements.

  • In any Performance Year in which CMS elects to make Coordinated Care Reward payments, the ACO shall ensure that all Next Generation Participants and Preferred Providers will, upon any Next Generation Beneficiary’s inquiry about the Coordinated Care Reward, provide an accurate and current list of all Next Generation Participants and Preferred Providers, either in hard copy or by reference to the ACO’s website, to the Next Generation Beneficiary.

  • Enrollment Verification The Division, or its duly authorized representative, shall provide the Contractor on a monthly basis a listing of all Coordinated Care enrollees who have selected or been assigned to the Contractor’s plan.

  • The Contractor must develop, administer, implement, monitor, and evaluate a program to promote health education services for its new and continuing Coordinated Care enrollees, as indicated below.

  • Other services provided include California Children’s Services; Child Health and Disability Prevention program; the Genetically Handicapped Persons Program; the Newborn Hearing Screening Program; the Family Planning, Access, Care, and Treatment (PACT) program; Program of All-Inclusive Care for the Elderly (PACE), Every Woman Counts, and Coordinated Care Management.

  • The Chief Executive Officer or a comparable representative shall serve as Contract Officer for the Contractor, with full decision-making authority for the Coordinated Care Organization, and will be required to be physically located in the State of Mississippi.

  • This system shall distinguish Coordinated Care from commercial enrollees if the Contractor does not have a separate system for Coordinated Care enrollees.

  • All enrollment, disenrollment and educational documents and materials made available to Coordinated Care enrollees by the Contractor must be submitted to the Division for its review annually, unless specified elsewhere in this contract.


More Definitions of Coordinated Care

Coordinated Care means covered expenses that have been referred by a Participant’s designated Primary Care Physician. The following services do not require a referral (OBGYN, Behavioral Health, Fertility Services, Habilitative Services (i.e. physical, occupational, speech therapy), Acupuncture, Chiropractic Care, Laboratory and Pathology Services, Emergency Services and Urgent Care). All other services will require a referral in order to be covered as “Coordinated Care”. “Coordinated Care” requires the use of a physician or facility participating in the network. Fertility services are administered by Kindbody.
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Related to Coordinated Care

  • Coordinated care organization means an organization meeting criteria adopted by the

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

  • Child care means continuous care and supervision of five or more qualifying children that is:

  • 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.

  • Coordination means the process through which the infrastructure manager and applicants will attempt to resolve situations in which there are conflicting applications for infrastructure capacity;