Managed Health Care Services definition

Managed Health Care Services means clinical and financial risk assessment and management of healthcare, with a view to facilitating appropriateness and cost effectiveness of relevant health services within the constraints of what is affordable, through the use of rules-based and clinical management-based programmes. Also refer to Part II;
Sample 1Sample 2Sample 3
Managed Health Care Services means clinical and financial risk assessment and management of health care, with a view to facilitating appropriateness and cost effectiveness of relevant health services within the constraints of what is affordable, through the use of rules, clinical management and system-based initiatives and programmes;
Sample 1Sample 2Sample 3

Examples of Managed Health Care Services in a sentence

  • Department of Managed Health Care Services (DMHC) — The California state agency that oversees health plans that operate as health maintenance organizations (HMOs), which includes most MCPs and MMPs.Demonstration Health Plan — The health plans selected to participate in the duals demonstration.

  • Effective use of Managed Health Care Services: Educational interventions designed to assist Members to effectively use the managed health care system, preventive and primary healthcare services, obstetrical care, and health education services; and appropriately use complementary and alternative care.

  • The UT Medical Branch received $299 million in payments from the Correctional Managed Health Care Committee for fiscal year 2006.Correctional Managed Health Care Services Provided bythe UT Medical BranchThe University of Texas Medical Branch at Galveston (UT Medical Branch) provides managed health care to offenders in more than 100 adult and juvenile correctional facilities throughout the state.

  • The Commission is also tasked to ensure compliance with health, safety and environmental standards in petroleum activities in accordance with applicable laws, regulations and agreements set forth by the Republic of Ghana.

  • Schemes Managed Health Care Services- Chronic Disease Management programme.

  • Don’t Leave the Country / Province Without Travel Insurance NSED Travel Insurance FAQ’s NSED Travel Insurance NSTU Group Insurance Travel Renewal FAQ’s How to Submit a Medoc Travel Claim Out of Province / Canada Travel Presentation March 1, 2016 Managed Health Care Services Inc.

  • Chapter 4The Health Sciences Center Had Adequate Processes for Its Costs Associated With Correctional Managed Health Care Services Chapter 4 Rating:Low 18The Health Sciences Center’s processes ensured that it complied with its TDCJ-Health Sciences Center contract (Contract), as well as reporting requirements.The Health Sciences Center ensured that its Program medical service payments, pharmaceutical purchases, and salary transactions adhered to contract requirements.Medical Services.

  • A particular interest is given to the fate of Pathogens, and especially of E.

  • Medical Branch - Galveston: Discussion and appropriate action regarding legal issues concerning contracts to provide Correctional Managed Health Care Services to offenders in units operated by the Texas Department of Criminal Justice (TDCJ) No action was taken on this item.

  • For example, on June 14, 2000, when PacifiCare announced via the PR Newswire its withdrawal from a couple of markets in the Midwest, it stated: HEADLINE: PacifiCare Health Systems Announces Exit From Ohio and Kentucky Markets; Managed Health Care Services Company to Exit Midwest by End of 2000 And Focus on Western United States PacifiCare Health Systems, Inc.

Related to Managed Health Care Services

  • Health care services means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.

  • Home health care services means medical and nonmedical services, provided to ill, disabled or infirm persons in their residences. Such services may include homemaker services, assistance with activities of daily living and respite care services.

  • COVERED HEALTHCARE SERVICES means any service, treatment, procedure, facility, equipment, drug, device, or supply that we have reviewed and determined is eligible for reimbursement under this plan.

  • Health care service means that service offered or provided by health care facilities and health care providers relating to the prevention, cure, or treatment of illness, injury, or disease.

  • Basic health care services means in and out-of-area emergency services, inpatient hospital and

  • PREVENTIVE CARE SERVICES means covered healthcare services performed to prevent the occurrence of disease as defined by the Affordable Care Act (ACA). See Preventive Care and Early Detection Services in Section 3. PRIMARY CARE PROVIDER (PCP) means, for the purpose of this plan, professional providers that are family practitioners, internists, and pediatricians. For the purpose of this plan, gynecologists, obstetricians, nurse practitioners, and physician assistants may be credentialed as PCPs. To find a PCP or check that your provider is a PCP, please use the “Find a Doctor” tool on our website or call Customer Service.

  • Foster care services means the provision of a full range of casework, treatment and community

  • Primary care services means the services in respect of which NHS England has a duty or power to make arrangements pursuant to the Primary Care Functions;

  • Healthcare services means all inpatient services (i.e., acute-care diagnostic and therapeutic inpatient hospital services), outpatient services (i.e., acute-care diagnostic and therapeutic outpatient services, including but not limited to ambulatory surgery and radiology services), and professional services (i.e., medical services provided by physicians or other licensed medical professionals) to the extent offered by Defendant and within the scope of services covered on an in-network basis pursuant to a contract between Defendant and an Insurer. “Healthcare Services” does not mean management of patient care, such as through population health programs or employee or group wellness programs.

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Licensed health care professional means a person who possesses a professional medical license that is valid in Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner (NP), licensed practical nurse (LPN), medical doctor (MD), osteopathic physician (DO), respiratory therapist (RT), physical therapist (PT), physician assistant (PA), or occupational therapist (OT).

  • Personal care services means both physical assis- tance and/or prompting and supervising the performance of direct personal care tasks as determined by the resident's needs and does not include assistance with tasks performed by a licensed health professional.

  • Health care provider or "provider" means:

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

  • Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.

  • 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.

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.

  • Health-related services means services that may have an effect on the health of individuals but are not health services or social care services;

  • Indian Health Care Provider means a health care program operated by the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian Organization (otherwise known as an I/T/U) as those terms are defined in § 4 of the Indian Health Care Improvement Act (25 USC § 1603). Indian Health Care Provider includes a 638 Facility and provision of Indian Health Service Contract Health Services (IHS CHS).

  • Federal Health Care Program means any “federal health care program” as defined in 42 U.S.C. § 1320a-7b(f), including Medicare, state Medicaid programs, state CHIP programs, the Veterans Administration, TRICARE and similar or successor programs with or for the benefit of any Governmental Authority, and in each case any third party payor administering such programs.

  • Health care professional means a physician or other health care practitioner licensed, accredited or certified to perform specified health care services consistent with state law.