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For more information visit our privacy policy.The exclusion does not apply to services billed to a Medicaid Care Management Organization (CMO).
Health care organization ’ means any person or en-
Procurement organization means an eye bank, organ procurement organization, or tissue bank.
Coordinated care organization means an organization meeting criteria adopted by the
Organ procurement organization means a person designated by the Secretary of the United States Department of Health and Human Services as an organ procurement organization.
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 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 plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:
Health care services means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.
Provider Organization means a group practice, facility, or organization that is:
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.
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.
Managed care plan means a health benefit plan that either requires a covered person to use, or
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;
Child Care Program means a person or business that offers child care.
Medicaid program means the Kansas program of medical
Child care services means the range of activities and programs provided by a certificate holder to an enrolled child, including personal care, supervision, education, guidance, and transportation.
Review organization means a disability insurer regulated
Family child care provider means a person who: (a) Provides
Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.
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.
Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.
Health plan or "health benefit plan" means any policy,
Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.
Utilization review organization means a person that conducts utilization review, other than a health carrier performing a review for its own health plans.
Medicare Provider Agreement means an agreement entered into between CMS or other such entity administering the Medicare program on behalf of CMS, and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.
Iowa Medicaid enterprise means the entity comprised of department staff and contractors responsible for the management and reimbursement of Medicaid services.