Enrollment Report definition

Enrollment Report means the list of Medicaid recipients who are enrolled with an HMO as Members for the month the report was issued. EPSDT means the federally mandated Early and Periodic Screening, Diagnosis and Treatment program contained at 42 USC 1396d(r) (see definition for Texas Health Steps). The name has been changed to Texas Health Steps (THSteps) in the State of Texas.

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Enrollment Report. The method by which the Department notifies the Contractor of members assigned to its health plan, as described in the Managed Care Technical Manual.

Enrollment Report shall have the meaning ascribed to it in Section 2.4(a).

Examples of Enrollment Report in a sentence

For Controlled Affiliates not underwriting the indemnity portion of workers’ compensation insurance: An amount equal to its pro rata share of Sponsoring Plan's dues payable to BCBSA computed with the addition of the Controlled Affiliate's members using the Marks on health care plans and related services as reported on the Quarterly Enrollment Report with BCBSA.
Controlled Affiliate will pay BCBSA a fee for this license in accordance with the following formula: An amount equal to its pro rata share of each Controlling Plan dues payable to BCBSA computed with the addition of the Controlled Affiliate's members using the Marks on regional PDP products and related services as reported on the Quarterly Enrollment Report with BCBSA.
Controlled Affiliate will pay BCBSA a fee for this license in accordance with the following formula: An amount equal to its pro rata share of each Controlling Plan dues payable to BCBSA computed with the addition of the Controlled Affiliate's members using the Marks on regional MAPPO products and related services as reported on the Quarterly Enrollment Report with BCBSA.
For third-party administrative business, an amount equal to its pro rata share of Sponsoring Plan’s dues payable to BCBSA computed with the addition of the Controlled Affiliate’s members using the Marks on health care plans and related services as reported on the Quarterly Enrollment Report with BCBSA.
For third-party administrative business, an amount equal to its pro rata share of each sponsoring Plan’s dues payable to BCBSA computed with the addition of the Controlled Affiliate’s members using the Marks on health care plans and related services as reported on the Quarterly Enrollment Report with BCBSA.
For Controlled Affiliates not underwriting the indemnity portion of workers’ compensation insurance: An amount equal to its pro rata share of each sponsoring Plan’s dues payable to BCBSA computed with the addition of the Controlled Affiliate’s members using the Marks on health care plans and related services as reported on the Quarterly Enrollment Report with BCBSA.
All members listed as an ADD or CONTINUE on either the Initial or Final County Enrollment Report are members of the County Managed Care Program during the enrollment month.
Controlled Affiliate will pay BCBSA a fee for this license in accordance with the following formula: An amount equal to its pro rata share of each Controlling Plan dues payable to BCBSA computed with the addition of the Controlled Affiliate’s members using the Marks on regional MAPPO products and related services as reported on the Quarterly Enrollment Report with BCBSA.
It shall be reconciled to the Health Plan Enrollment Report processed by the Agency or its Agent for the applicable month and shall be reviewed by the Agency or its Agent for compliance with acceptable reasons for Disenrollment.
The Initial County Enrollment Report will be available to the County on or about the twenty-first day of each month.

More Definitions of Enrollment Report

Enrollment Report means a data file provided by the Department to the plan that lists all clients enrolled in the plan and disenrolled for the enrollment month. The enrollment report is used as the basis for the monthly capitation payments.

Enrollment Report. The method by which the Department notifies the Contractor of members assigned to its health plan, as described in the Managed Care Technical Manual. “Every Reasonable Effort” This is Contractor-initiated action related to assessments, screenings, laboratory tests, immunizations, follow-up treatment or other services. Every reasonable effort shall include at a minimum a telephone call or mailed reminder either prior to the due date of each visit or upon learning that a visit has been missed and scheduling appointments for members. In the case of being notified of a missed appointment, a telephone “Exclusion from Managed Care/Exclusion from Medallion 4.0/ Exclusion from FAMIS” The removal of a member from the Medallion 4.0 and/or FAMIS Program on a temporary or permanent basis.

Enrollment Report. The method by which the Department notifies the Contractor of members assigned to its health plan, as described in the Managed Care Technical Manual. “Every Reasonable Effort” This is Contractor-initiated action related to assessments, screenings, laboratory tests, immunizations, follow-up treatment or other services. Every reasonable effort shall include at a minimum a telephone call or mailed reminder either prior to the due date of each visit or upon learning that a visit has been missed and scheduling appointments for members. In the case of being notified of a missed appointment, a telephone call or mailed reminder for the missed appointment is required. In the case of EPSDT, if there is no response, a personal visit to urge the parent or guardian to take the child to his or her appointment is required. “Exclusion from Managed Care/Exclusion from Medallion 4.0/ Exclusion from FAMIS” The removal of a member from the Medallion 4.0 and/or FAMIS Program on a temporary or permanent basis.

Enrollment Report has the meaning set forth in Section 2.9(a)