Examples of Provider Preventable Condition in a sentence
Provider Preventable Condition means a condition that meets the definition of a Health Care- Acquired Condition or an Other Provider-Preventable condition.
Provider Preventable Condition - A hospital acquired condition or a condition occurring in any health care setting that has been found by the State, based upon a review of medical literature by qualified professionals, to be reasonably preventable through the application of procedures supported by evidence-based guidelines, has a negative consequence for the Enrollee, and is auditable.
The Contractor’s policies and procedures shall also be consistent with the following: The Contractor shall not pay a provider for a Provider Preventable Condition.
Provider Preventable Condition – Health care-acquired condition means a condition occurring in a hospital setting, identified as HAC in the State Plan as described in Section 1886(d)(4)(D)(ii) and (iv) of the Social Security Act; other than Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) as related to total knee replacement or hip replacement surgery in pediatric and obstetric patients.
The Contractor‘s policies and procedures shall also be consistent with the following: The Contractor shall not pay a provider for a Provider Preventable Condition.
An ICO may limit reductions in provider payments to the extent that the following apply The identified Provider Preventable Condition would otherwise result in an increase in payment; The ICO can reasonably isolate for nonpayment the portion of the payment directly related to treatment for, and related to, the Provider Preventable Condition.
The Contractor’s policies and procedures shall also be consistent with the following: The Contractor shall not pay a Provider for a Provider Preventable Condition.
The ICO’s policies and procedures shall also be consistent with the following: The ICO shall not pay a provider for a Provider Preventable Condition.
A Contractor may limit reductions in Provider payments to the extent that the following apply: The identified Provider Preventable Condition would otherwise result in an increase in payment.
Provider Preventable Condition - A hospital acquired condition or a condition occurring in any health care setting that has been found by SCDHHS, based upon a review of medical literature by qualified professionals, to be reasonably preventable through the application of procedures supported by evidence-based guidelines, has a negative consequence for the Enrollee, and is auditable.