Medicaid Fiscal Agent definition

Medicaid Fiscal Agent means the state claims adjudication system for the Medical Assistance Program (Medicaid), also known as the Medicaid Management Information System (MMIS).
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Examples of Medicaid Fiscal Agent in a sentence

  • The County will notify the Department’s Medicaid Fiscal Agent in writing of all disenrollments and the reason for disenrollment.

  • The Medicaid Fiscal Agent contract defines the roles and responsibilities of the Medicaid fiscal contractor.

  • This information will be transmitted to the Medicaid Fiscal Agent.

  • For the execution of Medicaid provider agreement, item 7, the contracted entity is the Medicaid Fiscal Agent.

  • If the crisis unit determines that the child is eligible, the County will fax an enrollment form to the Department’s Medicaid Fiscal Agent.

  • For qualified provider enrollment, item 6, the agency is DMHA and the contracted entity is the Medicaid Fiscal Agent.

  • Function #5 – Utilization ManagementThe contracted entity is the Medicaid Surveillance Utilization Review Contractors, for qualified provider enrollment, item 6 the contracted entity is DMHA and Medicaid Fiscal Agent, for the execution of Medicaid provider agreement, item 7 the contracted entity is the Medicaid Fiscal Agent, and for the establishment of a consistent rate methodology for each State plan HCBS, item 8 the contracted entity is an actuarial service.

  • There is no Medicaid funding paid for someone not in active status with the Medicaid Fiscal Agent as of the date of service and no individual will be enrolled without a LOC, so there is never an issue of payments made incorrectly.

  • Overall with a project as large as transitioning to a new Medicaid Fiscal Agent, there are bound to be challenges for everyone as we all learn and work in a new system.

  • The Department’s Medicaid Fiscal Agent will determine if a member is BadgerCare Plus eligible, through 18 years of age, does not have a nursing home authorization, and is not residing in a psychiatric hospital.

Related to Medicaid Fiscal Agent

  • Medicaid means that government-sponsored entitlement program under Title XIX, P.L. 89-97 of the Social Security Act, which provides federal grants to states for medical assistance based on specific eligibility criteria, as set forth on Section 1396, et seq. of Title 42 of the United States Code.

  • Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.

  • Medicaid Certification means a certification by a state agency or other entity responsible for certifying Medicaid providers and suppliers that a health care provider or supplier is in compliance with all the conditions of participation set forth in the Medicaid Regulations.

  • Medicaid program means the Kansas program of medical

  • Child care provider means a provider who receives compensation for providing child care services on a regular basis, including an ‘eligible child care provider’ (as defined in section 658P of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858n)).

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Emergency medical care provider means an individual who has been trained to provide emergency and nonemergency medical care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic, paramedic specialist or other certification levels recognized by the department before 1984 and who has been issued a certificate by the department.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Coordinated care organization means an organization meeting criteria adopted by the

  • Family child care provider means a person who: (a) Provides

  • Medicare Select issuer means an issuer offering, or seeking to offer, a Medicare Select policy or certificate.

  • Medicare means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.

  • Medicaid Regulations means, collectively, (i) all federal statutes (whether set forth in Title XIX of the Social Security Act or elsewhere) affecting the medical assistance program established by Title XIX of the Social Security Act and any statutes succeeding thereto; (ii) all applicable provisions of all federal rules, regulations, manuals and orders of all Governmental Authorities promulgated pursuant to or in connection with the statutes described in clause (i) above and all federal administrative, reimbursement and other guidelines of all Governmental Authorities having the force of law promulgated pursuant to or in connection with the statutes described in clause (i) above; (iii) all state statutes and plans for medical assistance enacted in connection with the statutes and provisions described in clauses (i) and (ii) above; and (iv) all applicable provisions of all rules, regulations, manuals and orders of all Governmental Authorities promulgated pursuant to or in connection with the statutes described in clause (iii) above and all state administrative, reimbursement and other guidelines of all Governmental Authorities having the force of law promulgated pursuant to or in connection with the statutes described in clause (ii) above, in each case as may be amended, supplemented or otherwise modified from time to time.

  • Medicaid Provider Agreement means an agreement entered into between a state agency or other such entity administering the Medicaid program and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicaid patients in accordance with the terms of the agreement and Medicaid Regulations.

  • Home care agency means any sole proprietorship,

  • Medicare cost report means CMS-2552-10, the cost report for electronic filing of

  • Servicer Policies and Practices means, with respect to the Servicer’s duties under Exhibit A to the Servicing Agreement, the policies and practices of the Servicer applicable to such duties that the Servicer follows with respect to comparable assets that it services for itself and, if applicable, others.

  • 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.

  • Primary care provider means a participating provider who supervises, coordinates, or provides initial care or continuing care to a covered person, and who may be required by the health carrier to initiate a referral for specialty care and maintain supervision of health care services rendered to the covered person.

  • Consumer customer means anyone acting outside their trade or profession in respect of the insurance cover requested or arranged.

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • Respiratory care practitioner means an individual who practices respiratory care.

  • Primary care physician means a physician qualified to be an attending physician according to ORS 656.005(12)(b)(A) and who is a general practitioner, family practitioner, or internal medicine practitioner.

  • Credit accident and health insurance means insurance on a debtor to provide

  • Delinquency Collection Policies and Procedures The delinquency collection policies and procedures of the Interim Servicer, a copy of which is attached to the Interim Servicing Agreement as Exhibit 11.

  • Accountable care organization or “ACO” means an organization of health care providers that has a formal legal structure, is identified by a federal Taxpayer Identification Number, and agrees to be accountable for the quality, cost, and overall care of the patients assigned to it.