Rate Cell definition

Rate Cell means a Population Risk Group for which a Capitation Rate has been determined.

Rate Cell means the pricing data attributed to an Enrollee to determine the monthly prepaid capitation payment that will be paid by the STATE to the MCO for health coverage of that Enrollee. A Rate Cell is determined based on Rate Cell determinants, which may consist of all or a part of the following, consistent with MMIS requirements: age, sex, county of residence, major program, eligibility type, living arrangement, Medicare status, rate cell category and product ID.

Rate Cell means covered eligibility categories segmented into sub-groups based on an analysis of similarities of the per capita costs, age, and gender of various populations.

Examples of Rate Cell in a sentence

• MCOs are responsible for delivery of EW services even if the EW Rate Cell component was not paid in a given month.

• HHSC will calculate the monthly Capitation Payments by multiplying the number of Members by each applicable Member Rate Cell.

• When a change to Rate Cell criteria has been entered in MMIS after the enrollment Cut-Off Date, the MCO will be paid at the rate corresponding to the new Rate Cell at the time of the MCO’s next Capitation Payment, unless the requirements provided for in this section are met.

• Upon re-enrollment, the STATE may update the Enrollee’s Rate Cell Category using information from the MCO, Care System, or MMIS/MAXIS.

• Rate Cell — A set of mutually exclusive categories of enrollees that is defined by one or more characteristics for the purpose of determining the Capitation rate and making a Capitation payment; such characteristics may include age, gender, eligibility category, and region or geographic area.

More Definitions of Rate Cell

Rate Cell. As defined in 42 C.F.R. § 438.2, a set of mutually exclusive categories of enrollees that is defined by one or more characteristics for the purpose of determining the capitation rate and making a capitation payment; such characteristics may include age, gender, eligibility category, and region or geographic area. Each enrollee should be categorized in one of the rate cells for each unique set of mutually exclusive benefits under the contract. “Rating Period” A period of 12 months selected by the State for which the actuarially sound capitation rates are developed and documented in the rate certification submitted to CMS as required by § 438.7(a). “Readily Accessible” Electronic information and services which comply with modern accessibility standards such as Section 508 guidelines, Section 504 of the Rehabilitation Act, and W3C's Web Content Accessibility Guidelines (WCAG) 2.0 AA and successor versions.

Rate Cell means each and everyseparate rate identified as a rate of general applicability.

Rate Cell means a set of mutually exclusive categories of enrollees that is defined by one or more characteristics for the purpose of determining the capitation rate and making a capitation payment; such characteristics may include age, gender, eligibility category, and region or geographic area.

Rate Cell means a set of mutually exclusive categories of enrollees that is defined by

Rate Cell means a Population Risk Group for which a Premium Rate has been determined. Real-Time Captioning also known as Communication Access Real-Time Translation (CART) means a process by which a trained individual uses a shorthand machine, a computer, and real-time translation software to type and simultaneously translate spoken language into text on a computer screen. Real Time Captioning is provided for individuals who are deaf, have Dental Services for Texas Children’s Medicaid and Children’s Health Insurance Program Contract No. HHS0002879-00003 Attachment B – Dental Contract Terms and Conditions hearing impairments, or have unintelligible speech. It is usually used to interpret spoken English into text English; but may be used to translate other spoken languages into text. Readily Accessible has the meaning assigned to it in 42 C.F.R. § 438.10.

Rate Cell means the category attributed to an Enrollee to determine the monthly prepaid capitation rate by the STATE to the HEALTH PLAN for health care coverage of that Enrollee. A Rate Cell is assigned based on Rate Cell determinants which may consist of all or a part of the following, consistent with MMIS requirements: age, sex, county of service, major program, eligibility type, living arrangement, Medicare status, and product ID.

Rate Cell means each and every separate rate identified in any planned rate adjustment for rates of general applicability.