Provider Prior Authorization definition

Provider Prior Authorization or “PPA” means an authorization, either through eXPRS or by submission to ODHS of a document acceptable to ODHS, for funding awarded in the SEPA for delivery of a particular DD Service by a particular Provider, and for Provider submission of Disbursement Claims for the DD Service, that specifies:
Provider Prior Authorization or “PPA” means an authorization, either through eXPRS or by submission to ODHS of a document acceptable to ODHS, for funding awarded in the SEPA for delivery of a particular DD Service by a particular Provider, and for Provider submission of Disbursement Claims for the DD Service, that specifies: a. the DD Service, b. the Provider, c. a period, during which the authorization may be used to support delivery of the DD Service by the Provider, d. whether the PPA is an “Opt Out” PPA for those Providers that are paid through a CPA and have fluctuating amounts in a specific month; or the PPA is for a specific amount authorized to the Provider for a specified time frame. If the PPA is for an amount for a specific Provider, the total amounts authorized in the PPAs cannot exceed the total SEPA amount for that time frame for that DD Service.
Provider Prior Authorization or “PPA” means an authorization, either through eXPRS or by submission to ODHS of a document acceptable to ODHS, for funding awarded in the SEPA for delivery of a particular DD Service by a particular Provider, and for Provider submission of Disbursement Claims for the DD Service, that specifies: a. the DD Service, b. the Provider, c. a period, during which the authorization may be used to support delivery of the DD Service by the Provider,

Examples of Provider Prior Authorization in a sentence

  • The Provider Prior Authorization Look up Tool allows providers to search for authorizations by enrollee, provider, authorization data, or submission/service dates.

  • Why in news?A Constitution Bench of the Supreme Court unanimously upheld the power of the President to abrogate Article 370 of the Constitution, which granted special status to the former State of Jammu and Kashmir (J&K).

  • All Claims must conform in format and content with requirements of the Wisconsin Department of Health Service Third Party Administrator (TPA), WPS Insurance Corporation and can be only submitted to WPS for payment after receipt of the Provider Prior Authorization (PPA) form from Milwaukee County DHHS Disabilities Services Division.

  • Please consult the CIIS Expenditure Guidelines for more information.• Once the CME confirms/approves the hours submitted by provider(s) the CME sends confirmation to ODDS.RNsupport@state.or.us• ODDS central office puts Provider Prior Authorization request into Pending status in the MMIS payment system for the next month of service.

  • The ODDS FAC must receive the ISP budget summary pages and Adult or Child Needs Assessment (ANA/CNA) Summary of Hours page, if not already submitted to ODDS, in order to create the SEPA and Provider Prior Authorization (PPA).

  • N ew Resources from Molina Provider Prior Authorization LookUp Tool - Live on the Molina Website M olina has upgraded the ability to determine whether a procedure code requires Prior Authorization with its new Prior Authorization LookUp Tool.

  • In addition, determine if the Provider Prior Authorization (PPA) for your county’s Case Management provider number is active.

  • Next you will see the Out of Area and Non-Network Provider Prior Authorization Process Links section.

  • Upon receipt and approval by ODDS of the form, ODDS will create a Provider Prior Authorization (PPA) in eXPRS.


More Definitions of Provider Prior Authorization

Provider Prior Authorization or “PPA” means an authorization, either through eXPRS or by submission to DHS of a document acceptable to DHS, for funding awarded in the SEPA for delivery of a particular DD Service by a particular Provider, and for Provider submission of Disbursement Claims for the DD Service, that specifies: a. the DD Service, b. the Provider, c. a period of time, during which the authorization may be used to support delivery of the DD Service by the Provider, d. whether the PPA is an “Opt Out” PPA for those Providers that are paid through a CPA and have fluctuating amounts in a specific month; or the PPA is for a specific amount authorized to the Provider for a specified time frame. If the PPA

Related to Provider Prior Authorization

  • Prior authorization means that we must approve the Services in advance in order for the Services to be covered.

  • Product Authorizations means any and all approvals, including applicable supplements, amendments, pre- and post-approvals, clearances, licenses, notifications, registrations, certifications or authorizations of any Governmental Authority, any Standard Body necessary for the manufacture, development, distribution, use storage, import, export, transport, promotion, marketing, sale or other commercialization of a Product in any country or jurisdiction.

  • Service Authorization means that Open Ecosystem Partner needs to meet specific qualification requirements for the products included in a “Service” Product Family that Open Ecosystem Partner wants to promote and offer Services for as set out in detail in the Open Ecosystem Program Guide.

  • Federal work authorization program means any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), D.L. 99-603.

  • Provider Agreements means all participation, provider and reimbursement agreements or arrangements now or hereafter in effect for the benefit of Tenant or any Manager in connection with the operation of any Facility relating to any right of payment or other claim arising out of or in connection with Tenant’s participation in any Third Party Payor Program.

  • Provider agreement means the signed, written, contractual agreement between the department and the provider of services or goods.

  • Sell Authorization means that Distributor needs to meet specific training and qualification requirements for each product included in an “On Premise” Product Family that Distributor wants to resell as set out in detail in the Distributor Program Guide and the applicable RSPI.

  • Consents, Clearances and Permits means all authorizations, licenses, approvals, registrations, permits, waivers, privileges, acknowledgements, agreements, or concessions required to be obtained from or provided by any concerned authority for the purpose of setting up of the generation facilities and/ or supply of power;

  • Work Authorization or “WA” means Buyer’s authorization in either electronic or tangible form for Supplier to conduct transactions under this Agreement in accordance with the applicable SOW (i.e., a purchase order, xxxx of lading, or other Buyer designated document). A SOW is a WA only if designated as such in writing by Buyer.

  • Company Authorizations is defined in Section 3.4(b).

  • Governmental Authorization means any permit, license, authorization, plan, directive, consent order or consent decree of or from any Governmental Authority.

  • Marketing Authorization Application or “MAA” means an application for Regulatory Approval (but excluding Pricing Approval) in any particular jurisdiction other than the U.S.

  • Governmental Authorizations means any approval, consent, license, permit, waiver, or other authorization issued, granted, given, or otherwise made available by or under the authority of any Governmental Entity or pursuant to any Legal Requirement.

  • Provider Manual means a working document, including but not limited to BCBSM published bulletins and provider notices, that provide specific guidelines and direction by which providers may meet their contractual responsibility as described in this Agreement. Provider Manuals are published on web-DENIS.

  • Medicaid Provider Agreement means an agreement entered into between a state agency or other such entity administering the Medicaid program and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicaid patients in accordance with the terms of the agreement and Medicaid Regulations.

  • Required Consents shall have the meaning set forth in Section 4.5.

  • Required Permits shall have the meaning set forth in Section 6.24.

  • Governmental Approvals means all authorizations, consents, approvals, licenses and exemptions of, registrations and filings with, and reports to, all Governmental Authorities.

  • Environmental Authorizations means all licenses, permits, orders, approvals, notices, registrations or other legal prerequisites for conducting the business of the Borrower or any Subsidiary required by any Environmental Requirement.

  • Regulatory Authorizations means all approvals, clearances, authorizations, registrations, certifications, licenses and permits granted by any Regulatory Authority, including all INDs and NDAs.

  • Necessary Authorizations means all approvals and licenses from, and all filings and registrations with, any governmental or other regulatory authority, including, without limiting the foregoing, the Licenses and all approvals, licenses, filings and registrations under the Communications Act, necessary in order to enable the Borrower and its Subsidiaries to own, construct, maintain, and operate communications tower facilities and to invest in other Persons who own, construct, maintain, manage and operate communications tower facilities.

  • ACH Authorization means the ACH Debit Authorization Agreement in substantially the form of Exhibit H, which account numbers shall be redacted for security purposes if and when filed publicly by the Borrower.

  • Required Governmental Approvals means the Company Required Governmental Approvals and the Parent Required Governmental Approvals.

  • Provider contract means any contract between a provider and a carrier (or a carrier's network,

  • Required Consent has the meaning set forth in Section 4.4.

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.