Medicare Administrative Contractor definition

Medicare Administrative Contractor means a contractor designated by the Centers for Medicare and Medicaid Services for the administration of the Medicare program in each applicable jurisdiction.
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Medicare Administrative Contractor means a private healthcare insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service beneficiaries.
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Medicare Administrative Contractor has the meaning set forth in Section 911(a) of the Medicare Prescription Drug Improvement, and Modernization Act of 2003, as amended.
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Examples of Medicare Administrative Contractor in a sentence

  • The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract.

  • For Medicare Administrative Contractors (MACs):The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract.

  • FUNDING:For Medicare Administrative Contractors (MACs):The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract.

  • The Medicare Administrative Contractor (MAC) is hereby advised that this constitutes technical direction as defined in your contract.

  • The RO notifies the applicable Medicare Administrative Contractor (MAC) via the Form CMS 2007 of the termination of the provider/supplier’s Medicare agreement, including the effective date of the termination.

  • FUNDING: For Medicare Administrative Contractors (MACs):The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract.

  • Questions regarding eligibility/benefit data for Medicare Part A and Part B should be directed to the appropriate regional Medicare Administrative Contractor (MAC).

  • No additional funding will be provided by CMS; Contractor activities are to be carried out within their operating budgets.For Medicare Administrative Contractors (MACs):The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract.

  • No additional funding will be provided by CMS; contractor activities are to be carried out within their operating budgets.For Medicare Administrative Contractors (MACs):The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract.

  • Any physician or non-physician practitioner (NPP) authorized to bill Medicare services will be paid by the Medicare Administrative Contractor (MAC) at the appropriate physician fee schedule amount based on the rendering UPIN/PIN.

Related to Medicare Administrative Contractor

  • 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.

  • 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.

  • 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.

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

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

  • Specialty contractor means a person who is licensed to conduct business as described in subsection 4 of NRS 624.215.

  • Dependent care assistance program or "DCAP" means a benefit plan whereby school employees may pay for certain employment related dependent care with pretax dollars as provided in the salary reduction plan under chapter 41.05 RCW pursuant to 26 U.S.C. Sec. 129 or other sections of the Internal Revenue Code.

  • Emergency medical services personnel means that term as defined in section 20904 of the public health code, 1978 PA 368, MCL 333.20904.

  • 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.

  • Non-Administrator Dialysis Facility means a Dialysis Facility which does not have an agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan but has been certified in accordance with the guidelines established by Medicare.

  • 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.

  • 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.

  • 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.

  • Mental health services provider means an individual, licensed or unlicensed, who performs or purports to perform mental health services, including a:

  • 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.

  • Medical provider means a medical service provider, a hospital, a medical clinic, or a vendor of medical services.

  • HMO a health maintenance organization doing business as such (or required to qualify or to be licensed as such) under HMO Regulations.

  • 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.

  • PJM Administrative Service means the services provided by PJM pursuant to Tariff, Schedule 9.

  • primary carer means the person who has responsibility for the care of the Child. Only one person can be the Child’s Primary Carer on a particular day.

  • Direct care worker means a paid individual who provides direct, personal care services to persons with disabilities or the elderly requiring long-term care (see also the definition of long-term care worker, which includes direct care workers).

  • 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.

  • 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.

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

  • Provider is any individual or company that provides professional or technical services.

  • Medical care facility as used in this title, means any institution, place, building or agency, whether