Patient liability definition

Patient liability means the individual's financial obligation toward the medicaid cost of care.

Patient liability means the individual's financial obligation toward the medicaid cost of care. Patient liability shall be satisfied in accordance with rule 5160:1-3-04.3 of the Administrative Code.

Patient liability. The amount of a Covered Person’s income, as determined by the Division of TennCare, to be collected each month to help pay for the Covered Person’s Long-Term Services and Supports.

Examples of Patient liability in a sentence

• Cost Share or Patient Liability Members may be required to pay a monthly cost share or patient liability in order to be eligible for Family Care or Partnership.

• As specified in section A.2.6.7 of the CRA, Provider or collection agencies acting on Provider's behalf may not bill Covered Persons for amounts other than applicable TennCare cost sharing or Patient Liability amounts for Covered Services, including but not limited to, services that the State, Health Plan or Subcontractor has not paid for, except as permitted by the Division of TennCare rules and regulations and as described below.

• The State will notify the Contractor of any applicable Patient Liability amounts via the HIPAA standard 820 Premium Payment file, and the retroactive monthly amounts via the HIPPAA standard 834 Eligibility file.

• As specified in section A.2.6.7 of the CRA, Provider or collection agencies acting on Provider's behalf may not bill Covered Persons for amounts other than applicable TennCare cost sharing or Patient Liability amounts for Covered Services, including but not limited to, services that the State or United has not paid for, except as permitted by the Division of TennCare rules and regulations and as described below.

• Cost Share or Patient Liability Members may be required to pay a monthly cost share or patient liability in order to be eligible for Medicaid.

More Definitions of Patient liability

Patient liability means the financial amount an individual is required to contribute toward cost of care in order to maintain Medicaid eligibility.

Patient liability. The amount of an enrollee’s income, as determined by the State, to be collected each month to help pay for the enrollee’s long-term care services. Pharmacy Benefits Manager (PBM) – An entity responsible for the provision and administration of pharmacy services. Plan of Care – As it pertains to Population Health the plan of care is a personalized plan to meet a member’s specific needs and contains the following elements: prioritized goals that consider member and care giver needs which are documented; a time frame for re-evaluation; the resources to be utilized; a plan for continuity of care, including transition of care and transfers; and uses a collaborative approach including family participation. The plan of care is built upon the information collected from the health assessment to actively engage the member in developing goals and identifying a course of action to respond to the members’ needs. The goals and actions in the plan of care must address medical, social, educational, and other services needed by the member. Providing educational materials alone does not meet the intent of this factor. As it pertains to CHOICES, the plan of care is a written plan developed by the CONTRACTOR in accordance with Section A.2.9.6.6 through a person-centered planning process that assesses the member’s needs and outlines the services and supports that will be provided to the member to meet their identified needs (including unpaid supports provided by family members and other caregivers, and paid services provided by the CONTRACTOR and other payor sources) and addresses the member’s health and long- term services and support needs in a manner that reflects member preferences and goals. The person- centered planning process is directed by the member with long-term support needs, and may include a representative whom the member has freely chosen and others chosen by the member to contribute to the process. This planning process, and the resulting person-centered plan of care, will assist the member in achieving personally defined outcomes in the most integrated community setting, ensure delivery of services in a manner that reflects personal preferences and choices, and contribute to the assurance of health and welfare.

Patient liability means the individual's financial obligation toward the medical cost of care." Ohio Adm.Code 5101:1-39-24(B)(22). The procedure for determining an individual's patient liability is set forth in Ohio Adm.Code 5101:1-39-24(C)(2), which states:

Patient liability. The amount of an enrollee’s income, as determined by DHS, to be collected each month to help pay for the enrollee’s long-term care services. Pharmacy Benefits Manager (PBM) – An entity responsible for the provision and administration of pharmacy services. Post-stabilization Care Services – Covered services, related to an emergency medical condition that are provided after a member is stabilized in order to maintain the stabilized condition, or, under the circumstances described in 42 CFR 438.114(e), to improve or resolve the member’s condition. Prepaid Limited Health Service Organization (PLHSO) – An entity certified by TDCI under applicable provisions of TCA Title 56, Chapter 51.

Patient liability. The amount of an enrollee’s income, as determined by DHS, to be collected each month to help pay for the enrollee’s long-term care services. Pharmacy Benefits Manager (PBM) – An entity responsible for the provision and administration of pharmacy services. Plan of Care – As it pertains to Population Health it is a personalized plan to meet a member’s specific needs and contains the following elements: prioritized goals that consider member and care giver needs which are documented; a time frame for re-evaluation; the resources to be utilized; a plan for continuity of care, including transition of care and transfers; and uses a collaborative approach including family participation. The plan of care is built upon the information collected from the health assessment to actively engage the member in developing goals and identifying a course of action to respond to the members’ needs. The goals and actions in the plan of care must address medical, social, educational, and other services needed by the member. Providing educational materials alone does not meet the intent of this factor.

Patient liability. The amount of an enrollee’s income, as determined by the State, to be collected each month to help pay for the enrollee’s long-term care services.

Patient liability means all payments owed to Hospital by a Registered Patient, such as deductibles, co-payments, payments for elective procedures and all other payments that are not covered by third-party insurers.