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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DRG payment means)) - The total payment made by the ((department)) agency for a client's inpatient hospital stay. ((This)) The DRG payment ((allowed amount is calcu- lated by multiplying the conversion factor by the DRG rela- tive weight assigned by the department to provider's inpatient claim before any outlier payment calculation)) is the DRG allowed amount plus the high outlier minus any third-party liability, client participation, medicare payment, and any other adjustments applied by the agency.
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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.

  • To qualify, a new technology or medical service must demonstrate that it is a substantial clinical improvement over technologies or services otherwise available, and that, absent an add-on payment, it would be inadequately paid under the regular DRG payment.

  • No payment will be made for waiver days.See rule 441—78.31(249A) for policies regarding payment of hospital outpatient services.If the recipient is eligible for inpatient or outpatient hospital care through the Medicare program, payment will be made for deductibles and coinsurance as set out in 441—subrule 79.1(22).The DRG payment calculations include any special services required by the hospital, including a private room.

  • The Hospital Readmissions Reduction Program requires a reduction to a hospital’s base operating DRG payment to account for excess readmissions of selected applicable conditions.

  • The DSH adjustment is applied only to the Federal portion of the operating cost DRG payment (including outlier payments).

  • Adjustments are made in the Federal portion of the operating cost DRG payment to increase payments to hospitals serving a disproportionate share of low-income patients.

  • The DRG payment a hospital receives includes the interim operating cost DSH payment and an interim operating indirect medical education adjustment.

  • The DRG payment is proportionately reduced in cases where some of the days of the hospital stay are not covered by the Florida Medicaid fee-for-service program.

  • The additional payment equals the Federal portion of the operating cost DRG payment and outlier payments, but excludes any additional payments for the costs of indirect medical education multiplied by an adjustment percentage.

  • The basic components which make up DRG payment on an individual claim are shown below.

Related to DRG payment

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

  • Closing Payment Amount has the meaning specified in Section 1.5.

  • 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.

  • PRE-PAYMENT The Tenant shall: (check one)

  • Lump Sum Payment means, collectively, the lump-sum payments that may be payable to Executive pursuant to the first sentence of Subsection 6(b)(iii) and pursuant to Subsection 6(c)(ii)(B).

  • Option Payment shall have the meaning set forth in Section 3.4.

  • Delta Payment means as it is described in this Agreement.

  • PAGA Payment means the penalties pursuant to PAGA that the Parties have agreed is a

  • Cash Payment has the meaning set forth in Section 2.02(a).

  • AHYDO Payment means any mandatory prepayment or redemption pursuant to the terms of any Indebtedness that is intended or designed to cause such Indebtedness not to be treated as an “applicable high yield discount obligation” within the meaning of Section 163(i) of the Code.

  • Earnout Payment has the meaning set forth in Section 2.3(b).

  • Termination Payment has the meaning set forth in Section 6.03.

  • Settlement Payment means the transfer, or contractual undertaking (including by automated clearing house transaction) to effect a transfer, of cash or other property to effect a Settlement.

  • Basic Rent Payment Date means Basic Rent Payment Date as defined in Paragraph 6.

  • Upfront Payment has the meaning set forth in Section 4.1.

  • Installment Payment has the meaning ascribed to it in Section 2.02(a).

  • Reimbursement Payment shall have the meaning given to that term in Subparagraph 2.02(c).

  • Monthly Payment Amount means, with respect to each Payment Date, a payment equal to the amount of interest which has accrued during the related Interest Accrual Period, computed at the Interest Rate.

  • Delayed contribution payment means an amount paid by an employee for purchase of current service. The amount shall be determined using the same formula in KRS 61.5525, and the payment shall not be picked up by the employer. A delayed contribution payment shall be deposited to the member's account and considered as accumulated contributions of the individual member. In determining payments under this subsection, the formula found in this subsection shall prevail over the one found in KRS 212.434;

  • Compensation Payment means a payment, whether in monetary form or in the form of a benefit or service, by or on behalf of an insurer to a complainant to compensate the complainant for a proven or estimated financial loss incurred as a result of the insurer’s contravention, non-compliance, action, failure to act, or unfair treatment forming the basis of the complaint, where the insurer accepts liability for having caused the loss concerned, but excludes any –

  • Tax Payment Date means, with respect to any applicable Taxes, the date occurring 30 days prior to the date the same are due and payable.

  • Advance Payment shall have the meaning set forth in Clause 19.2; “Affected Party” shall have the meaning set forth in Clause 21.1;

  • Payment Amount as defined in Section 3.5.

  • Rent Payment means the amount payable by Lessee for the Assets as specified in the applicable Schedule.