Medicaid Providers definition

Medicaid Providers means the physicians, hospitals and other health care providers that have contracted with Seller and/or Seller’s Affiliates to provide covered health care services to Medicaid Members.
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Medicaid Providers. Please READ BOTH this page and the next page ENTIRELY before completing EFT application. ❖ Note: If all steps have not been completed correctly the approval process may be delayed or your application may be denied Medicaid Providers must submit this form to receive payment directly into their bank account. The funds can be credited to either a checking or savings account. When enrolling, please complete a separate Electronic Funds Transfer (EFT) Form for each Billing Provider if they do not have the same Tax Identification Number. Ifthe Tax Identification number is the same. billing providers can be listed on one application. In order to enroll you must complete the following steps:
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Medicaid Providers. Please READ BOTH this page and the next page ENTIRELY before completing EFT application. ❖ Note: If all steps have not been completed correctly the approval process may be delayed or your application may be denied Medicaid Providers must submit this form to receive payment directly into their bank account. The funds can be credited to either a checking or savings account. When enrolling, please complete a separate Electronic Funds Transfer (EFT) Form for each Billing Provider if they do not have the same Tax Identification Number. Ifthe Tax Identification number is the same. billing providers can be listed on one application. In order to enroll you must complete the following steps: ❖ Complete Provider Identifier Form ❖ Complete Automated Clearing House (ACH) /Direct Deposit Form • An official bank letter (must be dated within the last 12 months) OR a voided check must be attached to ACH form. ❖ Complete the Vendor Information form (new EFT/ACH applicants ONLY). ❖ Complete the attached W-9 Form: • If you are filling out a new EFT application or are re-enrolling, THE W-9 form MUST BE COMPLETED • If you are ONLY updating your bank information, the W-9 form is not necessary. All signed documents must be dated within 30 days. IMPORTANT: It is the responsibility of the provider to ensure the banking information is updated. as needed. If you have a new bank account your EFT will be routed to, please be sure to provide updated banking information at least 2 weeks before the current account closes. Special cases such as fraud, are an exception; provide updated information as soon as possible. Please keep in mind your application must go through an approval process that consist of multiple Government Agencies. Please allow at least six to eight weeks to establish your direct deposit account. To check the status of a new, changed or cancelled EFT enrollment, contact the Division of Public and Private Provider Services at xxxx.xxxxxxxxxxxxx@xx.xxx Revised 10/01/2024 Page 1 of 4 {Failure ta fa/law all be/aw instructions will result in a delay in the approval process or a denied application.) • Please provide an email that is actively used, to ensure you receive verification email(s), or questions/concerns regarding your application. (Verification emails MUST be responded to within 10 days. Check all folders, junk/spam included) • PO Boxes are not allowed on the W9, a physical address must be used. • An official bank letter OR voided check must be attached to the ACH f...
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Examples of Medicaid Providers in a sentence

  • For Providers that are not Medicare-certified or are not Medicaid Providers, the Contractor shall search for the Provider and its director.

  • Medicaid Information Bulletin (MIB) means the official, periodic publication of the Division of Integrated Healthcare to update the Utah Medicaid Provider Manual or issue information to Medicaid Providers.

  • The MCO must notify the STATE as soon as possible of significant events affecting the level of service either by the MCO or its Medicare and Medicaid Providers or subcontractors.

  • Such changes include both Medicare and Medicaid Providers, and pharmacy benefit managers as applicable, or 4) loss of the contractual agreement with a major subcontractor providing a network of providers, including but not limited to the MCO’s dental or behavioral health network, pharmacy benefit manager, care systems and care coordination entities.

  • The application contains separate paths of execution for cache hits and cache misses.

  • Within this process, the MCO must respond fully and completely to each Medicaid Provider's claims payment appeal and establish a tracking mechanism to document the status and final disposition of each appeal.

  • All PASSE providers will be required to enroll as Medicaid Providers and undergo criminal background checks, and child maltreatment and adult maltreatment registry checks.

  • The Contractor must accept all NFs, SCNF, ALs, CRSs that serve residents with traumatic brain injury, and long term care pharmacies which are Medicaid Providers, and network participation of these provider types cannot be denied based on the application of a subjective standard.

  • Operators that participate in Medicaid will be expected to conduct this self-assessment either as part of their initial application process to become DC Medicaid Providers, or as part of their re-enrollment process (whichever comes first).

  • The MCO shall coordinate the referral of Medicaid MCO Members for services that are outside of the required Core Benefits and which will continue to be provided by enrolled Medicaid Providers.


More Definitions of Medicaid Providers

Medicaid Providers means the physicians, hospitals and other health care providers that have contracted with any of the Companies or any of their Affiliates to provide covered health care services to Medicaid Members.
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Related to Medicaid Providers

  • 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.

  • 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.

  • 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.

  • 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.

  • Providers means individuals or organizations --------- licensed to practice dentistry (including specialists) as well as other dental professionals who provide ancillary reimbursable dental services.

  • Professional Provider means a Physician, Dentist, Podiatrist, Psychologist, Chiropractor, Optometrist or any Provider designated by the Claim Administrator or another Blue Cross and/or Blue Shield Plan.

  • 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.

  • 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.

  • 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.

  • Provider Personnel means all persons employed or engaged by the Provider together with the Provider’s servants, agents, consultants and Sub-Contractors (and all persons employed by any Sub-Contractor together with the Sub-Contractor’s servants, consultants, agents, Provider’s and Sub-Contractors) used in the performance of its obligations under this Agreement;

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Licensed health professional means a physician; physician assistant; nurse practitioner; physical, speech or occupational therapist; registered professional nurse; licensed practical nurse; or licensed or certified social worker.

  • Contractor Personnel means Contractor’s employees and subcontractors (as well as any employees or subcontractors of those subcontractors) performing the Services.

  • Emergency medical services provider means a person who has received formal training in prehospital and emergency care, and is licensed to attend any person who is ill or injured or who has a disability. Police officers, firefighters, funeral home employees and other persons serving in a dual capacity one of which meets the definition of “emergency medical services provider” are “emergency medical services providers” within the meaning of this chapter.

  • Health care facility or "facility" means hospices licensed

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79

  • 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.

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

  • New Jersey Stormwater Best Management Practices (BMP) Manual or “BMP Manual” means the manual maintained by the Department providing, in part, design specifications, removal rates, calculation methods, and soil testing procedures approved by the Department as being capable of contributing to the achievement of the stormwater management standards specified in this chapter. The BMP Manual is periodically amended by the Department as necessary to provide design specifications on additional best management practices and new information on already included practices reflecting the best available current information regarding the particular practice and the Department’s determination as to the ability of that best management practice to contribute to compliance with the standards contained in this chapter. Alternative stormwater management measures, removal rates, or calculation methods may be utilized, subject to any limitations specified in this chapter, provided the design engineer demonstrates to the municipality, in accordance with Section IV.F. of this ordinance and N.J.A.C. 7:8-5.2(g), that the proposed measure and its design will contribute to achievement of the design and performance standards established by this chapter.

  • Safety Management System means a systematic approach to managing safety, including the necessary organisational structures, accountabilities, policies and procedures;

  • Medical personnel means those persons assigned, by a Party to the conflict, exclusively to the medical purposes enumerated under sub-paragraph (e) or to the administration of medical units or to the operation or administration of medical transports. Such assignments may be either permanent or temporary. The term includes:

  • Quality Management System means a set of interrelated or interacting elements that organisations use to direct and control how quality policies are implemented and quality objectives are achieved;

  • Contractor Key Personnel means the Contractor Project Manager and those Project Staff members identified as “Key Personnel” as set forth in a Statement of Work.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Patients means both Public Patients and the Private Patients (referred by private doctors/private hospitals);