Grouping Methodology Sample Clauses

Grouping Methodology. When the MCOP uses a grouping methodology to pay inpatient and/or outpatient hospital claims, or ambulatory surgery center (ASC) claims, they are expected to utilize the same grouper software and inpatient only procedure listing (determined by Medicare and 3M) that ODM uses to process fee-for-service claims. 1. For inpatient hospital claims, the MCOP shall use the 3M All-Patient Refined Diagnosis Related Grouper (APR-DRG) and utilize the same version that ODM uses. 2. For outpatient hospital claims and ASC claims, the MCOP shall use the 3M Enhanced Ambulatory Patient Grouping (EAPG) and utilize the same version that ODM uses.
View SourceView Similar (35)

Related to Grouping Methodology

  • Methodology 1. The price at which the Assuming Institution sells or disposes of Qualified Financial Contracts will be deemed to be the fair market value of such contracts, if such sale or disposition occurs at prevailing market rates within a predefined timetable as agreed upon by the Assuming Institution and the Receiver. 2. In valuing all other Qualified Financial Contracts, the following principles will apply:

  • Accounting Method For both financial and tax reporting purposes, the books and records of the Company shall be kept on the accrual method of accounting applied in a consistent manner and shall reflect all Company transactions and be appropriate and adequate for the Company’s business.

  • Payment Methodology The Grantee shall be reimbursed for actual, reasonable, and necessary costs based upon the Grant Budget, not to exceed the Maximum Liability established in Section 1. Upon progress toward the completion of the Scope, as described in Section A of this Grant Contract, the Grantee shall submit invoices prior to any reimbursement of allowable costs.