Common use of Indicator Form Clause in Contracts

Indicator Form. Form supplied to inpatient hospitals by EOHHS that is used to notify the Contractor when the hospital discovers that an Enrollee has comprehensive insurance coverage other than Medicare or Medicaid. Total Capitation Rate Revenue — The sum of the monthly capitation payments for Demonstration Year 1 (reflecting coverage of Medicare Parts A/B services, Medicare Part D services and Medicaid services, pursuant to Appendix A and defined in Appendix B of this Contract) including: The application of risk adjustment methodologies, as described in