DRG payment definition

DRG payment means the payment made by the department for a client's inpatient hospital stay. This DRG payment allowed amount is calculated by multiplying the conversion factor by the DRG relative weight assigned by the department to provider's inpatient claim before any outlier payment calculation.
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Examples of DRG payment in a sentence

  • In these cases, the Contractor will remain financially responsible for the hospital DRG payment and any outlier payments (without a capitation payment) until the member is discharged from the hospital or the member’s eligibility in Medicaid terminates.

  • In addition, the federal government follows a diagnosis-related group (DRG) payment system for certain institutional services provided under Medicare or Medicaid.

  • Consideration to implement a DRG payment or budgeting system involves addressing the eight steps listed below.

  • The expansive drug list is a derogatory hospital reimbursement system to the DRG payment set up by the Social Security Financing Act (LFSS) of 2004 which allow to finance all the drugs inscribed on the positive list “liste en sus” (LES).

  • In addition to the DRG payment specified in this paragraph, for transplants requiring organ acquisition, there will be an additional payment for the procurement of the applicable organ as reported in Provider's most recently filed D-4 (formerly D-6) Worksheet or successor form.

  • In these cases, the Contractor will remain financially responsible for the hospital DRG payment and any outlier payments (without a capitation payment) until the member is discharged from inates.

  • In parallel, preparatory work is underway for introduction of the DRG payment system for inpatient services, accompanied by hospital districts formation and activities aimed at enhancing health service provider autonomy, and possibly introducing legislative changes that would allow for the contracting of private entities for provision of services.

  • If the patient does not receive the subsequent care from another designated provider hospital, the claim is eligible for full DRG payment instead of the lesser Transfer DRG payment.

  • An amount equivalent to one hundred percent (100%) of the Medicare DRG payment rates and methodologies in effect on the date of service, less any payments, Copayments, Coinsurance and Deductibles.

  • DSS shall pay applicable Hospitals the amounts set forth in Exhibit 5 related to the disputed phase-in of GME costs factored into the inpatient hospital diagnosis-related group (DRG) payment system, which totals approximately $1.7 million.

Related to DRG payment

  • Closing Payment has the meaning set forth in Section 2.2.

  • Closing Payment Amount has the meaning set forth in Section 2.06(d).

  • Co-payment means a relatively small amount of money paid by the insured person towards the cost of each day in a private hospital per episode of care, with Latrobe paying the rest of the cost.

  • Down payment means all partial payments, whether made in cash or otherwise, received by or for the benefit of the seller before or substantially contemporaneous with either the execution of the installment sale contract or the delivery of the motor vehicle sold under that contract, whichever occurs later.

  • Interim Payment has the meaning specified in Section 10.1.