Managed Care Organization (MCO) definition

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).

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Managed Care Organization (MCO) means an organization having a certificate of authority or certificate of registration from the Washington State Office of Insurance Commissioner that contracts with HCA under a comprehensive risk contract to provide prepaid health care services to eligible HCA Enrollees under HCA managed care programs.

Managed Care Organization (MCO) 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” in Iowa Code section 514B.1.

Examples of Managed Care Organization (MCO) in a sentence

Contractor shall follow the EOHHS policy and procedures document titled, "EOHHS Medicaid Managed Care Organization (MCO) Requirements for Medicaid Member Demographic Changes." Contractor shall have a process for performing outreach calls and an approach for determining a member’s most recent address and accurate address and telephone number.
The Contractor will track and trend parity complaints, grievances and appeals on the EOHHS approved template at a time and frequency as specified in the EOHHS Medicaid Managed Care Organization (MCO) Requirements for Reporting and Non-Compliance.
Contractor shall follow the EOHHS policy and procedures document titled, "EOHHS Medicaid Managed Care Organization (MCO) Requirements for Medicaid Member Demographic Changes." The Contractor will ensure via its contracts that all subcontractors will report such changes in status to the Contractor.
Contractor shall follow the EOHHS policy and procedures document titled, “EOHHS Medicaid Managed Care Organization (MCO) Requirements for Medicaid Member Demographic Changes.” The Contractor will ensure via its contracts that all subcontractors will report such changes in status to the Contractor.

More Definitions of Managed Care Organization (MCO)

Managed Care Organization (MCO) means an organization licensed to manage, coordinate and assume financial risk on a capitated basis for the delivery of specified services to enrolled members from a certain geographic area. Also referred to as a managed care plan and managed care program.

Managed Care Organization (MCO) means the network of participating health care organizations that provide services to Medicaid participants in the Maryland HealthChoice Program.

Managed Care Organization (MCO) means an organization under contract to assist the Agency to meet the requirements established under ▇▇▇▇ ▇▇▇▇, §27-2-12.

Managed Care Organization (MCO) means an HMO contracted with the Department of Human Services to provide Iowa Medicaid members with comprehensive health care services, including physical health, behavioral health, and long-term services and supports.

Managed Care Organization (MCO) means a public or private organization, organized under the laws of any state, which:

Managed Care Organization (MCO) is a specific term that means an MCE defined in 42 CFR Part 438. A CCO is an MCO for its managed care contract(s) subject to federal managed care requirements specified in 42 CFR Part 438.¶