Managed Care Services definition

Managed Care Services means any system of health care delivery that attempts to control

Managed Care Services means the administration or management of a health care, pharmaceutical, vision or dental Plan utilizing cost control mechanisms, including, but not limited to utilization review, case management, disease management, pharmacy management, the use of a preferred provider medical, vision or dental network, or a health maintenance organization.

Managed Care Services means the management or administration by any entity that is not an Insured of any Sponsored Plan that is a health care, pharmaceutical, vision or dental plan, utilizing cost control mechanisms.

Examples of Managed Care Services in a sentence

• Upon revocation of any of the Delegated Activities, or any portion thereof, PacifiCare will resume responsibility for performing such activities, and Medical Group and its Participating Providers shall continue to cooperate with PacifiCare with respect to the performance of Managed Care Services.

• If reached, the CONTRACTOR will have the Member complete the CNA or follow the HSD approved declination process as outlined in 4.4.1.5 of the Medicaid Managed Care Services Agreement.

• The Department shall direct the Contractor to commence Managed Care Services under this Contract on October 1, 2011 unless doing so would violate this Contract or the requirement under 42 CFR Part 438 to provide Members with a choice between at least two Managed Care Organizations.

• State requirements must be met as specified in the Medicaid Managed Care Services Contract.

• Activity 1.1. Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) Selective Contracting RFP Activity 1.2. Shared Living Selective Contracting RFP Activity 1.3 Medicaid Managed Care Services 2.

More Definitions of Managed Care Services

Managed Care Services means and include any or all of THINC's managed care transaction services, which include claims submission, on-line (batch and real-time) eligibility, benefit plan detail, roster distribution, remittance advice distribution, online claims inquiry, electronic referral/pre-certification and authorization, and encounter submission, all as provided pursuant to the Managed Care Transaction Contract.

Managed Care Services. Means the Service Provider’s installation and hosting of the Software for the exclusive benefit of the Service Provider Customer.

Managed Care Services means any system of health care delivery that attempts to control or coordinate use of health care services in order to contain health care expenditures or improve quality of health care services.

Managed Care Services. Fees for services that follow are specific to individual County workers’ compensation claims and are paid to Contractor off the respective claim(s) as either an allocated or medical expense, as appropriate.

Managed Care Services means any system of health care payment or delivery that

Managed Care Services means a Third-Party Service Provider’s administration or management of a health care, pharmaceutical, vision or dental Sponsored Plan utilizing cost control mechanisms, including, but not limited to, utilization review, case management, disease management, pharmacy management, the use of a preferred provider medical, vision or dental network, or a health maintenance organization. Managed Care Services will not include (1) any services provided by a Self-Administered Plan and (2) any acts, errors or omissions in the rendering of or failure to render Medical Services by an Insured.

Managed Care Services means the services specified in Exhibit A to this Agreement.