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:
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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.
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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
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Examples of Provider Prior Authorization in a sentence

  • Health Insurance; Home and Community-Based Services; Hospice Services; Hospital Outpatient Care; Medical Necessity; Non-Participating Provider; Plan; Premium; Primary Care Provider; Prior Authorization; Provider; Provider Network; Single Preferred Drug List (sPDL); Special Health Care Needs; Specialist; and Urgent Care as required in 42 CFR § 438.10(c)(4)(i).

  • DHS will provide County with funding for DD 55 Services by entering a Service Element Prior Authorization (SEPA) and Provider Prior Authorization (PPA) based on the approved County workload model or its funding level for FTE staff.

  • 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.

  • 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 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,
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