Paid Provider definition

Paid Provider means a provider who is issued a provider number for purposes of submitting medical assistance program claims for payment by the Authority.
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Paid Provider means an individual or agency who meets the requirements to be a provider and who will provide services for a fee.
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Paid Provider means a provider who meets the requirements in this rule for enrollment, billing, and payment.
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Examples of Paid Provider in a sentence

  • Paid Provider # 6 187 192 Field Number Field Name Number of Bytes Starting Location Ending LocationN/ C Description/Mask 87.

  • The Contractor shall serve as the entry point for all initial Registered Child Development Home (CDH) and Child Care Assistance (CCA) Paid Provider Applications.

  • In order to complete the 'Medicare Paid Provider' and 'Medicare Paid You' columns for MSP claims, you must apportion the total amount Medicare paid on the claim among the approved service lines.

  • Example: Dates Of Service Services Provided Amount Charged Medicare ApprovedMedicare Paid Provider You May Be Billed See Notes SectionJohn Smith MD 123 West StreetJacksonville, FL 32231 06/06/951 Office/OutpatientVisit, Est (99214) $80.00 $57.25 $45.80 $0.00 b 06/06/951 Removal of Skin Lesion (11441) $65.00 $49.71 $14.20 $0.00 b,c 06/06/951 Destroy Benign/Premal.

  • The pay for performance measures are as follows:95% or above of all completed Registered Child Development Home (CDH) and Child Care Assistance (CCA) Paid Provider Applications shall be submitted to the Agency’s Centralized Child Care Unit each year (July 1st – June 30th), without the need for additional Agency follow-up, including but not limited to: missing documentation, unsigned documents, incorrect information, information not satisfying established criteria, etc.

  • This does not include providers enrolled through the use of the DMAP 3108 Managed Care Plan and FFS Non Paid Provider Application.

  • Charged$25,0002) Negotiated Discount $10,0003) Allowed Amount (#1 - #2)$15,0004) Deductible$3005) Remaining Allowable (#3 - #4)$14,7006) In-Network Coinsurance (#5 x 10%)$1,4707) Plan Paid Provider (#5 - #6)$13,2308) Member Paid Provider (#4 + #6)$1,770Traditional Medical Plan.

  • Charged$25,0002Negotiated Discount$10,0003Allowed Amount (#1 - #2)$15,0004Deductible$3005Remaining Allowable (#3 - #4)$14,7006In-Network Coinsurance (#5 x 10%)$1,470Plan Paid Provider (#5 - #6)$13,230Member Paid Provider (#4 + #6)$1,770In this example, the member’s $300 deductible is satisfied.

  • Paid Provider Remittance Advice: This will be received with each check.

  • MEAL PREPARATION AND CLEAN UPIndependent Natural Support Paid Provider and Natural Support Paid Provider Only Habilitation OutcomeMake only one choice indicating whether the member eats alone or with family.

Related to Paid Provider

  • Approved provider means a provider of services registered with the appropriate association or organization to render services to a member and approved by Latrobe to render services to its members.

  • Affiliated provider means a health professional, licensed hospital, licensed pharmacy, or any other institution, organization, or person that has entered into a participating provider contract, directly or indirectly, with a health maintenance organization to render 1 or more health services to an enrollee. Affiliated provider includes a person described in this subdivision that has entered into a written arrangement with another person, including, but not limited to, a physician hospital organization or physician organization, that contracts directly with a health maintenance organization.

  • Preferred Provider or “Network Provider” means a doctor, hospital, medical facility or other provider of health care which is included in a network which has been designated by the Fund to render health related services to Fund participants.

  • Registered Provider means a registered provider of social housing (see section 80 of the Housing and Regeneration Act 2008);

  • Participating provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.

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

  • First-tier Subcontractor means any Subcontractor that has a contract with the General Contractor.

  • 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.

  • 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.

  • 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.

  • Subcontractor means any supplier, distributor, vendor, or firm that furnishes supplies or services to or for a prime contractor or another subcontractor.