Examples of FES member in a sentence
For purposes of this adjustment, any portion of a day during which the FES member receives treatment for an emergency medical condition is counted as an AHCCCS covered day.2. If the covered day reduction factor unadjusted is greater than one, then the covered day reduction factor final is one; otherwise, the covered day reduction factor final is equal to the covered day reduction factor unadjusted.
The number of AHCCCS covered days is equal to the number of inpatient days during which an FES member receives services for an emergency medical condition as described in R9-22-217.
Subsection (D) was added to clarify that the Administration is responsible for payment of behavioral health services received by an ALTCS FFS or FES member and that CRS is responsible for payment of behavioral health services provided to members enrolled with CRS..R9-22-1203 Subsection (B) was stricken and combined with Subsection (A) for clarify when a member is eligible to receive behavioral health covered services.
A hospital, emergency room provider, or fiscal agent shall notify a contractor, ADHS/DBHS, or a subcontractor of ADHS/DBHS, whichever is appropriate, no later than the 11th day from presentation of the non- FES member for emergency inpatient behavioral health services.
Covered Day Adjusted DRG Base Payment and Covered Day Adjusted Outlier Add-on Payment for FES membersIn addition to the covered day reduction factor in R9-22-712.69, a covered day reduction factor unadjusted is determined for an inpatient stay during which an FES member receives services for the treatment of an emergency medical condition and also receives services once the condition no longer meets the criteria as an emergency medical condition described in R9-22-217.
A provider shall notify the Administration no later than 72 hours after a FES member receiving emergency medical or behavioral health services presents to a hospital for inpatient services.
Guidehouse has documented the population trends and cost analysis in its full report, which also includes multiple methods for capturing and appropriately accounting for the providers costs for the Part C and FES programs.Population Trend AnalysisThe report also describes Part C and FES member count trends as reported in the provider survey over four years from SFY2019 through SFY 2022.