Outlier Allowable Fee definition

Outlier Allowable Fee means [Billed Charges - (MS-DRG Allowable Fee + Outlier Threshold)] x Marginal Cost Factor.
Outlier Allowable Fee means [Billed Charges - (MS-DRG Allowable Fee + Outlier Threshold)] x Marginal Cost Factor.‌
Outlier Allowable Fee means [Billed Charges - (MS-DRG Allowable Fee + Outlier

Examples of Outlier Allowable Fee in a sentence

  • We undertake that in case due to any change in facts or circumstances during the Bidding Process, we are attracted by the provisions of disqualification in terms of the provisions of this RFQ cum RFP, we shall intimate the Authority of the same immediately.

  • Any singular term in this Quality Agreement shall be deemed to include the plural, and any plural term the singular.

  • For Outlier cases, DOC shall base its payment to the Facility using an Outlier Allowable Fee plus the MS-DRG Allowable Fee.

Related to Outlier Allowable Fee

  • Maximum allowable cost list means a list of drugs for

  • Allowable Costs means the costs defined as allowable in 42 CFR, Chapter IV, Part 413, as amended to October 1, 2007, except for the purposes of calculating direct medical education costs, where only the reported costs of the interns and residents are allowed. Further, costs are allowable only to the extent that they relate to patient care; are reasonable, ordinary, and necessary; and are not in excess of what a prudent and cost-conscious buyer would pay for the given service or item.

  • Assigned Annual Special Tax means the Special Tax of that name described in Section D.

  • NOx Allowance means an authorization to emit a specified amount of NOx that is allocated or issued under an emissions trading or marketable permit program of any kind that has been established under the Clean Air Act or a state implementation plan.

  • Monthly Fee means the total consideration, including but not limited to, equipment or locker rental,

  • Maximum allowable cost means the maximum amount that a pharmacy benefit manager will reimburse a pharmacy for the cost of a drug.

  • Trust Reimbursement Amount As defined in Section 3.06A(a) of this Agreement.

  • Annual Special Tax means the Special Tax actually levied in any Fiscal Year on any Assessor’s Parcel.

  • Applicable Fee means, for any day, with respect to any Commitment, the applicable percentage set forth in Annex I under the caption “Applicable Fee”.

  • Monthly Fees means, collectively, [INSERT FOR HFS: the Monthly Food and Beverage Fee,] the Monthly Program Fee and the Monthly Royalty Fee, each of which is set forth in the Addendum. [INSERT FOR HFS: “Monthly Food and Beverage Fee” means the fee we require from you in Subsection 8.2, which is set forth in the Addendum.]

  • Allowable cost means a cost that complies with all legal requirements that apply to a particular federal education program, including statutes, regulations, guidance, applications, and approved grant awards.

  • Covered Expenses means expenses actually incurred by or on behalf of a Covered Person for treatment, services and supplies covered by the Policy. Coverage under the Participating Organization’s Policy must remain continuously in force from the date of the Covered Accident or Sickness until the date treatment, services or supplies are received for them to be a Covered Expense. A Covered Expense is deemed to be incurred on the date such treatment, service or supply, that gave rise to the expense or the charge, was rendered or obtained.

  • Expense Fee As to each Mortgage Loan and any Distribution Date, the product of the Expense Fee Rate and its Stated Principal Balance as of that Distribution Date.

  • Allowable Expenses means any Medically Necessary, Usual and Customary item of expense, at least a portion of which is covered under this Plan. When some Other Plan provides benefits in the form of services rather than cash payments, the reasonable cash value of each service rendered in the amount that would be payable in accordance with the terms of the Plan shall be deemed to be the benefit.

  • Program Expenses means all UHC’s expenses of administering the Program under the Indenture and the Act and shall include without limiting the generality of the foregoing; salaries, supplies, utilities, labor, materials, office rent, maintenance, furnishings, equipment, machinery and apparatus, including information processing equipment; software, insurance premiums, credit enhancement fees, legal, accounting, management, consulting and banking services and expenses; Fiduciary Expenses; remarketing fees; Costs of Issuance not paid from proceeds of Bonds; and payments to pension, retirement, health and hospitalization funds; and any other expenses required or permitted to be paid by UHC.

  • Maximum Applied Water Allowance (MAWA) means the upper limit of annual applied water for the established landscaped area as specified in Section 492.4. It is based upon the area's reference evapotranspiration, the ET Adjustment Factor, and the size of the landscape area. The Estimated Total Water Use shall not exceed the Maximum Applied Water Allowance. Special Landscape Areas, including recreation areas, areas permanently and solely dedicated to edible plants such as orchards and vegetable gardens, and areas irrigated with recycled water are subject to the MAWA with an ETAF not to exceed 1.0. MAWA = (ETo) (0.62) [(ETAF x LA) + ((1-ETAF) x SLA)]

  • Utilization Fee shall have the meaning assigned to such term in Section 2.06(b).

  • Capitalization Reimbursement Amount As to any Distribution Date, the amount of Advances or Servicing Advances that were added to the Stated Principal Balance of the related Mortgage Loans during the prior calendar month and reimbursed to the Master Servicer or Subservicer on or prior to such Distribution Date pursuant to Section 3.10(a)(vii), plus the Capitalization Reimbursement Shortfall Amount remaining unreimbursed from any prior Distribution Date and reimbursed to the Master Servicer or Subservicer on or prior to such Distribution Date.

  • Base Management Fee means the base management fee, calculated and payable quarterly in arrears, in an amount equal to one-fourth of 1.50% of the Company’s Equity.

  • Tuition Fee means the basic tuition fee applicable to specific programmes and shall include auxiliary fees which are for required instruction but shall exclude any other fees such as international student differential fees, co-op fees, and student union fees.

  • Special Allowance Payments means payments, designated as such, consisting of effective interest subsidies by the Department in respect of the Trust Student Loans to the Eligible Lender Trustee on behalf of the Trust in accordance with the Higher Education Act.

  • Development Fee means a fee for the packaging of a Property, including negotiating and approving plans, and undertaking to assist in obtaining zoning and necessary variances and necessary financing for the Property, either initially or at a later date.

  • Late Payment Fee means the excess of the Price Differential paid as a result of its calculation at the Post-Default Rate over the Price Differential as would have been calculated at the Pricing Rate.

  • Contract Fee means the price, fee, rent, or royalty payable in a contract under this chapter or

  • Monthly Service Fee means a monthly charge to a member for continuing care and not as rent, or a daily prorated portion thereof.

  • Maximum Special Tax means the maximum Special Tax, determined in accordance with Section C below, that can be levied in any Fiscal Year on any Assessor’s Parcel.