PIHP Administrative Services definition

PIHP Administrative Services. The health plan’s performance of services or functions, other than the direct delivery of Covered Services, necessary for the management of the delivery of and payment for Covered Services, including: network adequacy, service utilization, clinical or quality management, service authorization, claims processing, management information systems operation, and reporting. This term also includes the infrastructure development for, preparation of, and delivery of, all required Deliverables under the Contract, outside of the Covered Services.
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PIHP Administrative Services. The health plan’s performance of services or functions, other than the direct delivery of Covered Services, necessary for the management of the delivery of and payment for Covered Services, including: network adequacy, service utilization, clinical or quality management, service authorization, claims processing, management information systems operation, and reporting. This term also includes the infrastructure development for, preparation of, and delivery of, all required Deliverables under the Contract, outside of the Covered Services. PIHP Technical Workgroup: A workgroup composed of PIHP technical staff, contract administrators, claims processing, eligibility, and/or other PIHP staff, who meet as necessary; with Department staff from the Division of Medicaid Services (DMS), and staff from the Department’s Fiscal Agent. Plan: A plan is an individual or group plan that provides, or pays the cost of, medical care.
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Related to PIHP Administrative Services

  • Administrative Services means the provision to the Fund, by or at the expense of the Manager, of the following:

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

  • Administrative Services Agreement has the meaning set forth in Section 2.1(d).

  • Administration Services means the services required for the effective and efficient administration of Bonitas and includes, but are not necessarily limited to, member record management, contribution management, benefit option management, claims processing and management, management of members’ personal, claims and financial information and any other services that are required for the administration of Bonitas;

  • Supportive services means those services and activities provided in con- nection with minority business enter- prise programs which are designed to increase the total number of minority businesses active in the highway pro- gram and contribute to the growth and eventual self-sufficiency of individual minority businesses so that such busi- nesses may achieve proficiency to com- pete, on an equal basis, for contracts and subcontracts.

  • Habilitative services means those services provided by

  • Hospice services means palliative and supportive care and other services provided by an interdisciplinary team under the direction of an identifiable hospice administration to terminally ill hospice patients and their families to meet the physical, nutritional, emotional, social, spiritual, and special needs experienced during the final stages of illness, dying, and bereavement, as defined in Minnesota Statutes, § 144A.75, subd. 8, and includes the set of services as determined by the Medicare program under §1861(dd) of the Social Security Act and defined in 42 CFR § 418.3.

  • Child protective services means the identification, receipt and immediate response to complaints

  • Corporate Services Provider means Computershare Trust Company of Canada, a trust company formed under the laws of Canada, as corporate services provider to the Liquidation GP under the Corporate Services Agreement, together with any successor corporate services provider appointed from time to time;

  • Protective services means expedited services that are provided:

  • Child support services means any civil, criminal or administrative action taken by the Division of

  • Pharmacy services means the practice of pharmacy as defined in chapter 18.64 RCW and includes any drugs or devices as defined in chapter 18.64 RCW.

  • Basic health plan services means that schedule of covered

  • Education Services means education and hostel facilities for students and scholars provided by -

  • BPO Services means Provider’s business process outsourcing services described in the applicable Solution Exhibit, whereby Provider assumes responsibility for Customers’ business processes.

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

  • Distribution Services means the service of distribution, as defined in section 5 of the Act;

  • Administrative Staff means all persons employed by the University who are categorised in terms of the Statutes as members of the administrative staff;

  • Preventive services means preservation services, as defined

  • Outpatient services means those services rendered in a practitioner’s office or in the department of an approved facility where services are rendered to persons who have not had an overnight stay and are not charged for room and board.

  • Special Services means all forms of services pertaining

  • Transitional Services means services involving technical or specialized knowledge required to complete a project or to provide temporary consulting services to the City.

  • Information Services means the Municipal Securities Rulemaking Board’s Electronic Municipal Market Access System; or, such other services providing information with respect to called municipal obligations as the District may specify in writing to the Paying Agent or as the Paying Agent may select.

  • Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.

  • Family support services means providing opportunities for

  • Educational Services means educational training provided to Entitled Students at a School;