HMO Administrative Services definition

HMO Administrative Services means the performance of services or functions, other than the direct delivery of Covered Services, necessary for the management of the delivery of and payment for Covered Services, including but not limited to Network, utilization, clinical and/or quality management, service authorization, claims processing, management information systems operation and reporting.
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Examples of HMO Administrative Services in a sentence

  • A Material Subcontractor means any entity retained by the HMO to provide all or part of the HMO Administrative Services where the value of the subcontracted HMO Administrative Service(s) exceeds $100,000 per fiscal year.

  • Scott, Esq., as Chair, to sign to accept the terms of the Capital Blue Cross-PPO and Keystone Health Plan Central - HMO Administrative Services Only Contract agreements for the 2009 plan year.

  • Authenticators SHALL be bound to subscriber accounts by either: • Issuance by the CSP as part of enrollment; or• Associating a subscriber-provided authenticator that is acceptable to the CSP.These guidelines refer to the binding rather than the issuance of an authenticator as to accommodate both options.Throughout the digital identity lifecycle, CSPs SHALL maintain a record of all authenticators that are or have been associated with each identity.

  • HMO Administrative Services are those services or functions other than the direct delivery of Covered Services necessary to manage the delivery of and payment for Covered Services.

Related to HMO Administrative Services

  • Administrative Services means the provision to the Fund, by or at the expense of the Manager, of the following:

  • PJM Administrative Service means the services provided by PJM pursuant to Tariff, Schedule 9.

  • Administrative Services Agreement has the meaning set forth in Section 2.1(d).

  • Administration Services means the services required for the effective and efficient administration of Bonitas and includes, but are not necessarily limited to, member record management, contribution management, benefit option management, claims processing and management, management of members’ personal, claims and financial information and any other services that are required for the administration of Bonitas;

  • Child protective services means the identification, receipt and immediate response to complaints

  • Supportive services means social, health, educational, income support and employment services and benefits, coordination of community building and educational activities, individualized needs assessment, and individualized assistance with obtaining services and benefits.

  • Protective services means expedited services that are provided:

  • Habilitative services means those services provided by

  • Preventive services means preservation services, as defined

  • Corporate Services Provider means Computershare Trust Company of Canada, a trust company formed under the laws of Canada, as corporate services provider to the Liquidation GP under the Corporate Services Agreement, together with any successor corporate services provider appointed from time to time;

  • Basic health plan services means that schedule of covered

  • Hospice services means palliative and supportive care and other services provided by an interdisciplinary team under the direction of an identifiable hospice administration to terminally ill hospice patients and their families to meet the physical, nutritional, emotional, social, spiritual, and special needs experienced during the final stages of illness, dying, and bereavement, as defined in Minnesota Statutes, § 144A.75, subd. 8, and includes the set of services as determined by the Medicare program under §1861(dd) of the Social Security Act and defined in 42 CFR § 418.3.

  • Pharmacy services means the practice of pharmacy as defined in chapter 18.64 RCW and includes any drugs or devices as defined in chapter 18.64 RCW.

  • Education Services means training services performed or delivered by Company.

  • Extra Services means those services set forth in Schedule “B” that are requested by the Municipality for itself or on behalf of its citizens and provided by the Company in accordance with paragraph 7 of this Agreement;

  • administrative staff means all persons employed by the University who are categorised in terms of the Statutes as members of the administrative staff;

  • Company Services means any services (including but not limited to technical and product support, technical advice, underwriting and customer services) supplied by the Company or its Affiliates in the specialty property and/or casualty insurance business.

  • Authorized Services shall have the meaning as defined in the Master Agreement.

  • Account Information Service Provider means a payment service provider pursuing business activities as referred to in point (8) of Annex I;

  • Information Services means the Municipal Securities Rulemaking Board’s Electronic Municipal Market Access System; or, such other services providing information with respect to called municipal obligations as the District may specify in writing to the Paying Agent or as the Paying Agent may select.

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Investment Management Services means any services which involve: (i) the management of an investment account or Fund (or portions thereof or a group of investment accounts or Funds); (ii) the giving of advice with respect to the investment and/or reinvestment of assets or funds (or any group of assets or funds); or (iii) otherwise acting as an “investment adviser” within the meaning of the Investment Advisers Act of 1940, as amended, including, without limitation, in each of the foregoing cases, performing activities related or incidental thereto.

  • Sensitive Services means those services that (i) require access to Customer/Consumer Information, (ii) relate to the State’s computer networks, information systems, databases or secure facilities under circumstances that would permit modifications to such systems, or (iii) involve unsupervised access to secure facilities (“Sensitive Services”).

  • Mental health services provider means an individual, licensed or unlicensed, who performs or purports to perform mental health services, including a:

  • Emergency medical services provider means a person who has received formal training in prehospital and emergency care, and is licensed to attend any person who is ill or injured or who has a disability. Police officers, firefighters, funeral home employees and other persons serving in a dual capacity one of which meets the definition of “emergency medical services provider” are “emergency medical services providers” within the meaning of this chapter.

  • Long-term care services means services provided through the department of social and health services either in a hospital or skilled nursing facility, or in another setting under a home and community-based waiver authorized under 42 U.S.C. Sec. 1396n.