Medicaid Pending definition

Medicaid Pending means an amount that will be billed to Medicaid for services rendered to patients that are expected to qualify for such state Medicaid program, but which patients are at the time in question in the process of completing the necessary paperwork and have not yet been officially accepted by such state as eligible Medicaid patients.
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Medicaid Pending. A process in which individuals who apply for the Statewide Medicaid Managed Long-Term Care Program for HCBS and who meet medical eligibility choose to receive services before being determined financially eligible for Medicaid by DCF.
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Medicaid Pending means accounts which are still pending approval of coverage from Medicaid. “Medical Executive Committee” means the Eligible Recipient committee responsible for conveying accurately the views of the medical staff on all issues, including those issues relating to quality and safety. “Metropolitan Region” means, collectively, a substantially populated urban core and its surrounding towns, cities, territories, and other areas generally considered to share infrastructure, industry, or housing with such urban core. For illustrative purposes only, Southfield, Michigan and Dearborn, Michigan shall be considered to be within the same Metropolitan Region (i.e., the Detroit Metropolitan Region). “Middle” means those Dependent Services that are referred to as “Middle” in Exhibit 2-A. “Military Leave” has the meaning given in Exhibit 13, Section 1.1. “National Employee” has the meaning given in Exhibit 4-A, Section 8.1(i).
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Examples of Medicaid Pending in a sentence

  • INSTRUCTIONS: This report must include all enrollees currently enrolled in the Managed Care Plan, including all Medicaid Pending and SIXT enrollees, and the facility in which they are currently residing, if applicable.

  • INSTRUCTIONS: This report must include all enrollees currently enrolled in the Managed Care Plan, including all Medicaid Pending and SIXT enrollees, and the facility in which they are residing at the end of the reporting month, if applicable.

  • Due to small range of item difficulty and large range of person ability, misfit cannot be precisely located on the items.

  • For residents with Medicaid or Medicaid Pending Status, Facility will send invoice to Colorado Palliative & Hospice Care of Colorado Springs and Colorado Palliative & Hospice Care of Colorado Springs will bill Medicaid.

  • For residents with Medicaid or Medicaid Pending Status, Facility will send invoice to Colorado Palliative & Hospice Care and Colorado Palliative & Hospice Care will bill Medicaid.

  • General Administration Other (specify): 5180-5079-0-0Bad Debt - Resident102,3565180-5079-1-0Bad Debt - Resident - Recovery-5180-5080-0-0Bad Debt - Resident Prior Period-5180-5081-0-0Bad Debt - Medicaid Pending Denial52,5265180-5081-1-0Bad Debt - Medicaid Pending - Recovery-5180-5082-0-0Bad Debt - Medicaid Denial Prior Period-5180-5083-0-0Bad Debt - Medicaid MCO13,653PG3-14.5168,535 D.

  • The process for individuals who are Medicaid Pending is currently on hold and a policy for that process will be issued at a later date.

  • Cancellations do not include withdrawals once an individual is referred as Medicaid Pending and has received services.

  • An applicant is adjunctively income eligible for WIC if documentation shows that the individual or an immediate household member is certified as fully eligible to receive benefits from: - Supplemental Nutrition Assistance Program (SNAP/Food Stamps)- Temporary Assistance for Needy Families (TANF) program- Medicaid (Pending adjunctive eligibility)o DC Medicaid Programs exist which apply higher income eligibility guidelines than allowed by WIC.

  • Printed Name Printed Name Signature Signature Date Date Type of Service: ❑ Respite beginning on and ending on ❑ Resident ❑ Resident will be Private Pay ❑ Resident has Medicaid ❑ Resident is Medicaid Pending *Facility will send invoice to Colorado Palliative & Hospice Care at end of stay and bill patient if applicable.


More Definitions of Medicaid Pending

Medicaid Pending means that an application for Medicaid payment on behalf of a patient has not yet been approved by Medicaid.
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Medicaid Pending means accounts which are still pending approval of coverage from Medicaid.
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Related to Medicaid Pending

  • Medicaid program means the Kansas program of medical

  • 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.

  • 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.

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

  • 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.

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

  • Medicaid Certification means certification by CMS or a state agency or entity under contract with CMS that health care operations are in compliance with all the conditions of participation set forth in the Medicaid Regulations.

  • 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 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;

  • 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.

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Health care coverage means any plan providing hospital, medical or surgical care coverage for

  • Health care facility or "facility" means hospices licensed

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

  • TRICARE means, collectively, a program of medical benefits covering former and active members of the uniformed services and certain of their dependents, financed and administered by the United States Departments of Defense, Health and Human Services and Transportation, and all laws applicable to such programs.

  • Iowa Medicaid enterprise means the entity comprised of department staff and contractors responsible for the management and reimbursement of Medicaid services.

  • Health care facilities means buildings, structures, or equipment suitable and intended for, or incidental or ancillary to, use in providing health services, including, but not limited to, hospitals; hospital long-term care units; infirmaries; sanatoria; nursing homes; medical care facilities; outpatient clinics; ambulatory care facilities; surgical and diagnostic facilities; hospices; clinical laboratories; shared service facilities; laundries; meeting rooms; classrooms and other educational facilities; students', nurses', interns', or physicians' residences; administration buildings; facilities for use as or by health maintenance organizations; facilities for ambulance operations, advanced mobile emergency care services, and limited advanced mobile emergency care services; research facilities; facilities for the care of dependent children; maintenance, storage, and utility facilities; parking lots and structures; garages; office facilities not less than 80% of the net leasable space of which is intended for lease to or other use by direct providers of health care; facilities for the temporary lodging of outpatients or families of patients; residential facilities for use by the aged or disabled; and all necessary, useful, or related equipment, furnishings, and appurtenances and all lands necessary or convenient as sites for the health care facilities described in this subdivision.

  • Medicare Levy Surcharge means an extra charge payable by high income earners beyond the standard Medicare Levy if they do not have qualifying private hospital insurance coverage. This charge is assessed as part of an individual or family’s annual tax return.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Medicare Regulations means, collectively, (a) all Federal statues (whether set forth in Title XVIII of the Social Security Act or elsewhere) affecting the health insurance program for the aged and disabled established by Title XVIII of the Social Security Act and any statues succeeding thereto and (b) all applicable provisions of all rules, regulations, manuals and orders and administrative, reimbursement and other guidelines having the force of law of all Governmental Authorities (including CMS, the OIG, HHS or any person succeeding to the functions of any of the foregoing) promulgated pursuant to or in connection with any of the foregoing having the force of law, as each may be amended, supplemented or otherwise modified from time to time.

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

  • Residential child care facility means a twenty-four-hour residential facility where children live together with or are supervised by adults who are not their parents or relatives;

  • HMO means any health maintenance organization, managed care organization, any Person doing business as a health maintenance organization or managed care organization, or any Person required to qualify or be licensed as a health maintenance organization or managed care organization under applicable federal or state law (including, without limitation, HMO Regulations).

  • Health Care Authority or “HCA” means the Washington State Health Care Authority, any division, section, office, unit or other entity of HCA, or any of the officers or other officials lawfully representing HCA.

  • Medicare benefit means the Medicare benefit payable within the meaning of Part II of the Health Insurance Act 1973 with respect to a professional service.