Managed Care Business definition

Managed Care Business means either offering a Third-Party Payor Program or contracting with a Third-Party Payor Program, directly or indirectly, to arrange for the provision of health care items or services by a panel of contracted providers, in any manner whatsoever. Managed Care Business shall also mean the provision of management or administrative services to any party that engages in either of the foregoing.
Sample 1Sample 2
Managed Care Business means the businesses conducted by the Managed Care Companies; provided, however, that such business does not include any operations relating to the Small Group Business.
Sample 1Sample 2
Managed Care Business means value-based-managed care business operated by Prospect Medical, PHP Holdings, and certain of their respective Affiliates.
Sample 1

Examples of Managed Care Business in a sentence

  • Shareholder is a physician licensed to practice medicine in the State (as defined herein) and currently conducts a Managed Care Business through the Company.

  • Neither the Shareholder nor any of his Affiliates is, or with the last three (3) years was, a party to any contract, lease, agreement or arrangement, including, but not limited to, any joint venture or consulting agreement with any physician, hospital, pharmacy, home health agency, organization engaged in Managed Care Business or other person which is in a position to make or influence referrals to, or otherwise generate business for, the Company.

  • Subject to the whistleblower is not involved in the malpractice or misconduct, an employee who whistleblows internally shall be protected against any adverse employment actions (discharge, demotion, suspension, harassment, or other forms of discrimination) for raising allegations of businessmisconduct.

  • The term "Competing Managed Care Business" shall have the meaning set forth in Section 16.1(b).

  • As reviewed in Section 3, existing POMs as listed in Annex VI of the WFD do not provide an effective basis for the protection of high status sites, and alternative mechanisms (referred in the WFD as Supplementary Measures) are required.

  • BUSINESS CONTINUITY PLAN The Contractor shall adhere to all elements of the AHCCCS, Office of Managed Care Business Continuity Plan Policy.

  • Xxxxxxxxxxx 7/8/2004 $ 20,000.00 100,000 Xxxxxxx Xxxxxxx 7/8/2004 $ 25,000.00 125,000 Xxxxxxx Xxxxxxxxxx & Xxxx Xxxxxxxxxx JTWROS 7/8/2004 $ 20,000.00 100,000 Xxxxxx Xxxxxxx & Xxxxxxxxx Xxxxxxx JTWROS 7/8/2004 $ 25,000.00 125,000 Xxxxxx Xxx Xxxxxx 7/8/2004 $ 15,000.00 75,000 Xxxxxxx Xxxxxxxxxx & Xxxxx Xxxxxxxxxx JTWROS 7/8/2004 $ 10,000.00 50,000 Xxxxxxx Xxxxxx 7/8/2004 $ 50,000.00 250,000 Xxx Xxxxx 7/8/2004 $ 25,000.00 125,000 Xxxxx X.

  • Company may freely assign this Agreement; provided that, following the assignment of this Agreement by the Company, the definition of Managed Care Business shall not be expanded beyond the definition of such term at the date of such assignment without the prior written consent of Employee.

  • Joanie has 25 years’ experience in Health Insurance Systems and Managed Care Business Management, applying a strong expertise in insurance systems, back office management and Customer focused strategic planning.

  • Managed Care Business......................................................................


More Definitions of Managed Care Business

Managed Care Business means arrangements among health care providers, third-party payors and patients developed and managed by the Company or an Affiliate that through capitated payment arrangements or other financial incentives or disincentives and case management endeavor to eliminate inefficiencies in health care delivery and reduce unnecessary utilization of services while maintaining or improving quality of care. "Managed Care Plan"
Sample 1
Managed Care Business means any business, endeavor, enterprise, activity, arrangement or undertaking engaged in the provision of health care services, including, but not limited to Laboratory Testing, DME, HMS or diagnostic imaging services, by or through capitated plans. The term "Participate" shall mean any direct or indirect interest or position in or any financial or other arrangement or relationship with any business, arrangement or enterprise whether as an officer, director, employee, partner, shareholder, sole proprietor, joint venturer, agent, representative, independent contractor, consultant, franchisor, franchisee, creditor, owner or otherwise; provided that the term "Participate" shall not include ownership of less than two percent of the stock of a publicly-held corporation whose stock is traded on a national securities exchange or in the over- the-counter market.
Sample 1

Related to Managed Care Business

  • Managed care entity means either a managed care organization licensed by the department of insurance (e.g., HMO or PHP) or a primary care case management program (i.e., MediPASS).

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • Child care facility or “facility” means a child care center, a preschool, or a registered child development home.

  • Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.

  • Health care facilities means buildings, structures, or equipment suitable and intended for, or incidental or ancillary to, use in providing health services, including, but not limited to, hospitals; hospital long-term care units; infirmaries; sanatoria; nursing homes; medical care facilities; outpatient clinics; ambulatory care facilities; surgical and diagnostic facilities; hospices; clinical laboratories; shared service facilities; laundries; meeting rooms; classrooms and other educational facilities; students', nurses', interns', or physicians' residences; administration buildings; facilities for use as or by health maintenance organizations; facilities for ambulance operations, advanced mobile emergency care services, and limited advanced mobile emergency care services; research facilities; facilities for the care of dependent children; maintenance, storage, and utility facilities; parking lots and structures; garages; office facilities not less than 80% of the net leasable space of which is intended for lease to or other use by direct providers of health care; facilities for the temporary lodging of outpatients or families of patients; residential facilities for use by the aged or disabled; and all necessary, useful, or related equipment, furnishings, and appurtenances and all lands necessary or convenient as sites for the health care facilities described in this subdivision.

  • Managed Care Organization (MCO) means a contracted health delivery system providing capitated or prepaid health services, also known as a Prepaid Health Plan (PHP). An MCO is responsible for providing, arranging, and making reimbursement arrangements for covered services as governed by state and federal law. An MCO may be a Chemical Dependency Organization (CDO), Dental Care Organization (DCO), Mental Health Organization (MHO), or Physician Care Organization (PCO).

  • Managed care means a system that provides the coordinated delivery of services and supports that are necessary and appropriate, delivered in the least restrictive settings and in the least intrusive manner. Managed care seeks to balance three factors: achieving high-quality outcomes for participants, coordinating access, and containing costs.

  • the Business means the usual work and activities carried on by the Insured pertaining to his business as specified in the Schedule and no others.

  • Health care facility or "facility" means hospices licensed

  • food business means any undertaking, whether for profit or not and whether public or private, carrying out any of the activities related to any stage of production, processing and distribution of food;

  • Alarm business means the business by any individual, partnership, corporation, or other entity of selling, leasing, maintaining, servicing, repairing, altering, replacing, moving or installing any alarm system or causing to be sold, leased, maintained, serviced, repaired, altered, replaced, moved or installed any alarm system in or on any building, structure or facility.

  • Group care facility means an agency, other than a foster-family home, which is maintained and operated for the care of a group of children on a 24 hour basis. RCW 74.15.020

  • Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.

  • Adult foster care facility means an adult foster care facility licensed under the adult foster care facility licensing act, 1979 PA 218, MCL 400.701 to 400.737.

  • food business operator means the natural or legal persons responsible for ensuring that the requirements of food law are met within the food business under their control;

  • Healthcare Facility means that portion of the Project operated on the Land as a Nursing Home, Intermediate Care Facility, Board and Care Home, Assisted Living Facility, and/or any other healthcare facility authorized to receive mortgage insurance pursuant to Section 232 of the National Housing Act, as amended, including any commercial space included in the facility.

  • home business means a business, service or profession carried out in a dwelling or on land around a dwelling by an occupier of the dwelling which —

  • Licensed Business means the activities connected with the conveyance of

  • Authorized business means 1 of the following:

  • Managed health care system means: (a) Any health care

  • Eligible business means a business located within the counties of Cook, DuPage, Kane, Lake, McHenry or Will in the State of Illinois (the “Six County Region”), and as to which: (1) a majority of the business' fleet is located and used within the Six County Region; and (2) a majority of those vehicles located and used within the Six County Region are alternatively powered vehicles.

  • Medical care facility as used in this title, means any institution, place, building or agency, whether

  • Covered Business means (A) during the term, any business in which the Company is engaged and (B) after the Term, any business in which the Company was engaged as of the end of the Term.

  • Parent Business has the meaning set forth in the Separation and Distribution Agreement.