Reimbursement Methodology definition

Reimbursement Methodology means the methodology by which BCBSM determines the amount of payment due Provider for Covered Services.
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Reimbursement Methodology means the prospective Medicaid payment rate system for intermediate care facilities for the mentally retarded.
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Examples of Reimbursement Methodology in a sentence

  • BCBSM will pay Provider for Covered Services in accordance with the Reimbursement Methodology set forth in Addendum C.

  • BCBSM will timely process acceptable claims submitted by Provider and will make payment directly to Provider for Covered Services in accordance with the Reimbursement Methodology set forth in Addendum C.

  • Any material change to the Reimbursement Methodology will be in accordance with Section 6.6 of this Agreement.

  • BCBSM will give Provider not less than 90 days prior written notice of any material change to the Reimbursement Methodology.

  • BCBSM will give Provider not less than 90 days prior written notice of any material change to the Reimbursement Methodology set forth in this Addendum.

  • BCBSM will timely process Clean Claims submitted by Provider and will make payment directly to Provider for Covered Services in accordance with the Reimbursement Methodology set forth in Addendum C.

  • BCBSM will give Facility not less than 60 days prior written notice of any material change to the Reimbursement Methodology for freestanding Substance Abuse Facilities.

  • BCBSM will give Facility not less than 30 days prior written notice of any material change to the hospital-based Substance Abuse Facility Reimbursement Methodology.

  • BCBSM will timely process acceptable claims submitted by Facility and will make payment directly to Facility for Covered Services prescribed by a Physician or other health care provider licensed to prescribe such services in accordance with the Reimbursement Methodology set forth in Addendum C.

  • HealthChoice DPP Reimbursement Methodology for In-Person and Virtual DPP Providers Session/Event HCPCS Code and Description Payme nt Modifiers Limitation In-Person Make-up Session Virtual Session1 Virtual Make-Up Session Session 1 G98732 - 1st core session attended $100 None GT3 None Can be used 1 time in 365 days4 Session 2-4 G9874 - 4 total core sessions attended5 $120 TS6 GT VM7 Can be used 1 time in 365 days4 Virtual programs may only use VM to indicate make-up sessions.