Encounter Rate definition

Encounter Rate means the Encounter Rate set forth on the Order Form.

Encounter Rate means the all-inclusive PPS rate that the Department reimburses an FQHC for an encounter pursuant to 42 USC 1396a (bb);

Encounter Rate. The payment made to Medical Group for Covered Services rendered to a Customer during an encounter. Unless otherwise specified in this Appendix, such payment shall be considered payment in full, less any applicable Customer Expenses, for all Covered Services rendered to the Customer by the Medical Group. Payor shall pay Medical Group for covered Health Services rendered to Customers the lesser of (1) Medical Group’s Customary Charge, less any applicable Member Expense or (2) the applicable Case Rate less any applicable Member Expense.

Examples of Encounter Rate in a sentence

• The rate of payment shall be set at the Encounter Rate established by the IHS on an annual basis and published in the Federal Register.

• This means that the total payments may or may not be equal to the total Enhancement payments that are owed based on the actual number of visits that month. Third, a reconciliation process is conducted after the end of the year to ensure that the total payments received by each clinic from both the MCOs and HCA are equal to the clinic’s Encounter Rate times the number of visits Medicaid beneficiaries actually made to the clinic.

• Under state regulations, a Rural Health Clinic (RHC) is supposed to receive an Encounter Rate payment for each visit by a Medicaid beneficiary that is based on the clinic’s cost per visit.

• All Covered Services* Encounter Rate* [****] * The Encounter Rate Payment includes payment in full for all services and supplies billed during an entire patient encounter.

• If You select the Flat Monthly Rate, each Encounter that exceeds the maximum Encounter volume allotment will be subject to the per Encounter Rate specified in Exhibit A.

• The Encounter Rate will be paid, less any applicable Customer Expenses, for all Covered Services rendered to the Customer by the Medical Group, only once every six months from the initial date of service to the Customer, or first date of service after a six month period has expired, whichever is later.

• Additionally, FQHCs, RHCs, Encounter Rate Clinics and Critical Clinic Providers may bill these codes, fee-for-service, at the rate established by the Department as listed on the COVID-19 Fee Schedule.

• FQHC / RHC – The lesser of 100% of current Medicare Encounter Rate or PP/PPG’s billed charges minus any applicable copays, coinsurance or deductibles.

• The Percentage Fee, and the Encounter Rate shall only be applied to services and procedures performed on or after the First Charge Entry Date and until the Final Charge Submission Date; provided, however, that for Channel Transfer Clients, the Percentage Fee (or the Transferred A/R Percentage Fee, if applicable) shall in addition be applied to all charges existing in the Hosted Programs as of the First Charge Entry Date for which no payment has been posted.

• Approve the creation of a new project titled Oil Spill Encounter Rate Analysis with a budget transfer from the contingency fund not to exceed $30,000 for contractor support, and authorize the Executive Director to negotiate a contract in support of the project in an amount not to exceed $30,000.

More Definitions of Encounter Rate

Encounter Rate means the Anthem Rate that is all-inclusive of professional, technical and facility charges including evaluation and management, pharmaceuticals, routine surgical and therapeutic procedures, and diagnostic testing (including laboratory and radiology) capable of being performed on site. "Fee Schedule(s)" means the complete listing of Anthem Rate(s) for specific services that is payment for each unit of service allowed based on applicable Coded Service Identifier(s) for Covered Services.