Prior period coverage means the period prior to the member’s enrollment during which a member is eligible for covered services. PPC begins on the first day of the month of application or the first eligible month, whichever is later, and continues until the day the member is enrolled with a contractor.
Prior period coverage means the period of time from the first day of the month of application or the first eligible month whichever is later to the day a member is enrolled with the program contractor. The program contractor receives notifica- tion from the Administration of the member’s enrollment.
Prior period coverage. AHCCCS provides prior period coverage for the period of time, prior to the Title XIX member’s enrollment during which a member is eligible for covered services. Prior Period Coverage refers to the time frame from the effective date of eligibility to the day a member is enrolled with the Contractor. The Contractor receives notification from AHCCCS of the member’s enrollment. The Contractor is responsible for payment of all claims for medically necessary covered services, excluding most behavioral health services, provided to members during prior period coverage. This may include services provided prior to the contract year and in a Geographic Service Area where the Contractor was not contracted at the time of service delivery.
Examples of Prior period coverage in a sentence
Prior period coverage refers to the timeframe from the effective date of Medicaid eligibility to the day the Enrollee is enrolled with the Contractor.
Prior period coverage refers to the time frame from the effective date of eligibility (usually the first day of the month of application) until the date the member is enrolled with ALTCS DES/DDD.
Prior period coverage refers to the time frame from the effective date ofeligibility (usually the first day of the month of application) until the date the member is enrolled with the CRS Contractor.
Prior period coverage refers to the time frame from the effective date of eligibility (usually the first day of the month of application) until the date the member is enrolled with the RBHA.
More Definitions of Prior period coverage
Prior period coverage means the period of time prior to the member’s enrollment, during which a member is eligible for covered services. The timeframe is from the effective date of eligibility (usually the first day of the month of application) until the date the member is enrolled with the Contractor. Refer to 9 A.A.C. 22 Article 1. If a member made eligible via the Hospital Presumptive Eligibility (HPE) program is subsequently determined eligible for AHCCCS via the full application process, prior period coverage for the member will also be covered by AHCCCS fee for service and the member will be enrolled with the Contractor only on a prospective basis.