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).

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 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.

Examples of Managed Care Organization (MCO) in a sentence

• The employee must cooperate at all times in meeting with and in responding to information requests of the Managed Care Organization (MCO), BWC, the Risk Manager, and health providers.

• For a third party or Medicare Managed Care Organization (MCO) claim to be successfully captured, the Other Coverage Code field and Other Payer Amount Paid field must be entered.

• Individuals that do not select a Managed Care Organization (MCO) will be auto-assigned to an MCO with available capacity that accepts new enrollees in the county where the beneficiary lives.

• To remain eligible for Transitional Pay, the Employee must cooperate with, meet when reasonably requested, and respond to information requests from the Managed Care Organization (MCO), Third-Party Administrator (TPA), Risk Manager, health providers, and his/her supervisor.

• HealthChoice members must enroll in a Managed Care Organization (MCO).

More Definitions of Managed Care Organization (MCO)

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 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.

Managed Care Organization (MCO) means an entity under contract with the Department receiving capitated payments and at risk for providing reimbursement for enrollees.

Managed Care Organization (MCO) means, for the purposes of this Contract, an entity that has, or is seeking to qualify for, a comprehensive risk contract with the Department to provide Covered Services under the HFS Medical Program, as provided in 42 CFR §438.2. MCOs include HMOs and MCCNs.

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

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 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