Utilization Control definition

Utilization Control means the Department has implemented a statewide program of surveillance and utilization control that safeguards against unnecessary or inappropriate use of Medicaid services, safeguards against excess payments, and assesses the quality of services available under the plan. The program meets the requirements of 42 CFR, Part 456.
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Utilization Control means an overall accountability program encompassing quality management and utilization review.
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Utilization Control means a systematic process of
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Examples of Utilization Control in a sentence

  • Specify the entity: The Department's Utilization Control Agent (UCA).OtherSpecify: c.

  • Utilization Control  Certification and Technology Requirements 1.

  • If there are fluctuations in the particle ori- entations, however, the alignment of the particles is not perfect.

  • The MoWR will be initially responsible for this component through its Basin Development Study and Water Utilization Control Department and the Abbay River Basin Team until the Abbay River Basin Organization (ARBO) and the Tana Sub-basin Organization (TaSBO) and Beles Sub-basin Organization (BeSBO) are established.

  • Figure 3: Map of Lake Victoria Water Basin 2.3Legal FrameworkThe Lake Victoria Basin Water Board (LVBWB) was established in the year 2000 in accordance with the Water Utilization (Control and Regulation) Act No. 42 of 1974, as amended in the Act No. 10 of 1981, Section 7 (1).

  • The LTCF completes the top half of DHMH 257 and sends both the DHMH 257 and the DHMH 3871B to the Utilization Control agent (UCA) for completion.

  • The use of water in Tanzania is regulated by the Water Utilization (Control and Regulation) Act No. 42 of 1974, as amended in 1981, and the Water Utilization (General Regulations) of 1975.

  • Inefficient water uses, such as low efficiencies of many irrigation schemes, (esti- mated at 10% to 15%); and leakages from domestic water supplies estimated to cause water losses up to 52% of water that is produced; both of which contribute to reduction in water availability.1.3 Present Water Resources Management SystemThe Water Utilization (Control and Regulation) Act No. 42 of 1974 and its subsequent amendments govern the present water resources management system.

  • Residence in the LTCF and level of care are verified by the Utilization Control Agent (UCA), a private organization that is contracted by the Department to provide this information to the LDSS.

  • PacifiCare shall make an annual Utilization Control Program payment to IPA within one hundred and fifty (150) days of the end of each Year.


More Definitions of Utilization Control

Utilization Control means the control of covered health care services to assure the use of cost efficient, medically necessary or appropriate services.
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Utilization Control means an overall accountability program encompassing quality management and utilizationreview.
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Utilization Control means a systematic process of measures that assure overall management and cost containment of health care services.
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Utilization Control means an approved program instituted, implemented and operated by or under the authorization of a utilization review organization (URO) which effectively safeguards against unnecessary or inappropriate Medicaid/NJ FamilyCare services and assesses the quality of those services to Medicaid/NJ FamilyCare fee- for-service beneficiaries.
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Utilization Control means a systematic process of implementing measures that assure overall management and cost containment of services delivered, including compliance with practice parameters and protocols of treatment as provided for in this chapter.
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Related to Utilization Control

  • Utilization management section means “you or your authorized representative.” Your representative will also receive all notices and benefit determinations.

  • Utilization plan means a form and additional documentation included in all bids or proposals that demonstrates a vendor’s proposed utilization of vendors certified by the Business Enterprise Program to meet the targeted goal. The Utilization Plan shall demonstrate that the Vendor has either: (1) met the entire contract goal or (2) requested a full or partial waiver and made Good Faith Efforts towards meeting the goal.

  • Fertilization means the fusion of a human spermatozoon with a human ovum.

  • Utilization means public usage of the subway, bus, railroad

  • Stormwater management BMP means an excavation or embankment and related areas designed to retain stormwater runoff. A stormwater management BMP may either be normally dry (that is, a detention basin or infiltration system), retain water in a permanent pool (a retention basin), or be planted mainly with wetland vegetation (most constructed stormwater wetlands).

  • Stormwater management facility means a control measure that controls stormwater runoff and changes the characteristics of that runoff including, but not limited to, the quantity and quality, the period of release or the velocity of flow.

  • Targeted case management means services that assist a beneficiary to access needed 2 medical, educational, social, prevocational, vocational, rehabilitative, or other community services. The 3 service activities may include, but are not limited to, communication, coordination and referral;

  • Acceptable earned value management system means an earned value management system that generally complies with system criteria in paragraph (b) of this clause.

  • Stormwater management measure means any practice, technology, process, program, or other method intended to control or reduce stormwater runoff and associated pollutants, or to induce or control the infiltration or groundwater recharge of stormwater or to eliminate illicit or illegal non-stormwater discharges into stormwater conveyances.

  • Utilization Percentage means, as of any day, the fraction expressed as a percentage, the numerator of which is the Facility Usage on such day, and the denominator of which is the Borrowing Base in effect on such day.

  • Utilization review means the prospective (prior to), concurrent (during) or retrospective (after) review of any service to determine whether such service was properly authorized, constitutes a medically necessary service for purposes of benefit payment, and is a covered healthcare service under this plan. WE, US, and OUR means Blue Cross & Blue Shield of Rhode Island. WE, US, or OUR will have the same meaning whether italicized or not. YOU and YOUR means the subscriber or member enrolled for coverage under this agreement. YOU and YOUR will have the same meaning whether italicized or not.

  • Service Availability The total number of minutes in a calendar quarter that the Tyler Software is capable of receiving, processing, and responding to requests, excluding maintenance windows, Client Error Incidents and Force Majeure.

  • Stormwater management system means any equipment, plants,

  • Stormwater management plan means the set of drawings and other documents that comprise all the information and specifications for the programs, drainage systems, structures, BMPs, concepts and techniques intended to maintain or restore quality and quantity of stormwater runoff to pre-development levels.

  • air traffic control service means a service provided for the purpose of:

  • area control service means air traffic control service for controlled flights in control areas;

  • Earned value management system means an earned value management system that complies with the earned value management system guidelines in the ANSI/EIA-748.

  • Solid waste management facility means the same as that term is defined in Section 19-6-502.

  • Commitment Utilization Percentage means on any day the percentage equivalent to a fraction (a) the numerator of which is the aggregate outstanding principal amount of Revolving Credit Loans, including the aggregate outstanding principal amount of Letters of Credit, Swingline Loans and Competitive Loans, and (b) the denominator of which is the Total Commitment (or, on any day after termination of the Commitments, the Total Commitment in effect immediately preceding such termination).

  • Traffic control signal means a device, whether manually, electrically, or mechanically operated, by which traffic is alternately directed to stop and permitted to proceed.

  • Utilization Fee shall have the meaning assigned to such term in Section 2.06(b).

  • Virginia Stormwater Management Program or “VSMP” means a program approved by the State Board after September 13, 2011, that has been established by a locality to manage the quality and quantity of runoff resulting from land-disturbing activities and shall include such items as local ordinances, rules, permit requirements, annual standards and specifications, policies and guidelines, technical materials, and requirements for plan review, inspection, enforcement, where authorized in this article, and evaluation consistent with the requirements of this article and associated regulations.

  • Safety Management System means a systematic approach to managing safety, including the necessary organisational structures, accountabilities, policies and procedures;

  • Public Finance Management Act ’ means the Public Finance Management Act, 1999 (Act No. 1 of 1999);

  • Mobilization means establishment of sufficiently adequate infrastructure by the CONTRACTOR at "SITE" comprising of construction equipments, aids, tools tackles including setting of site offices with facilities such as power, water, communication etc. establishing manpower organisation comprising of Resident Engineers, Supervising personnel and an adequate strength of skilled, semi-skilled and un-skilled workers, who with the so established infrastructure shall be in a position to commence execution of work at site(s), in accordance with the agreed Time Schedule of Completion of Work. "MOBILISATION" shall be considered to have been achieved, if the CONTRACTOR is able to establish infrastructure as per Time Schedule, where so warranted in accordance with agreed schedule of work implementation to the satisfaction of ENGINEER-IN-CHARGE/ EMPLOYER.

  • Quality control means the total of all activities performed by the Design-Builder, Designer, Construction Inspection Professional Engineering Firm and the Materials Testing Firm or Laboratory, subcontractors, producers or manufacturers to ensure that the Work performed by the Design-Builder conforms to the Contract requirements. For design, Quality Control activities shall include, but not be limited to, procedures for design quality, checking, design review including reviews for constructability, and review and approval of Working Plans. For construction, Quality Control activities shall include, but not be limited to, procedures for materials handling and construction quality, inspection, sampling and testing of materials both on site and at the plant(s), field testing of materials, obtaining and verifying Materials Certifications, record keeping, and equipment monitoring and calibration, production process control, and monitoring of environmental compliance. Quality Control also includes documentation of all QC design and construction efforts. The Scope of Work to be performed as part of the Quality Control task may be changed after the RFQ Phase.