Capitated contract definition
Capitated contract means a contract between the Oklahoma
Capitated contract means a contract between OHCA and a contracted entity for the delivery of services to Medicaid members in which OHCA pays a fixed, per-member per-month rate based on actuarial calculations.
Capitated contract means a contract in which an insurer pays directly or indirectly a fixed amount to a health care provider in exchange for the future rendering of medical services for covered expenses.
Examples of Capitated contract in a sentence
The Contractor shall comply with Capitated contract rules established by PRICO, in accordance with Normative Letter CA-I-2-1232-91 (Attachment 13 to this Contract), which provides that every contract based on a Capitated payment arrangement prohibits the Provider from in turn subcontracting on a Capitated basis.
More Definitions of Capitated contract
Capitated contract. - This means contracts where eligibility is electronically provided by the payor, encounters are electronically processed, reimbursements are provided electronically, no charge entry is done by US Servis staff, at least 75% of the co-pays are collected and posted to the system by Client personnel, and capitation payments are posted to the system based upon a fixed, pre-agreed physician distribution formula.
Capitated contract means a contract between the Oklahoma Health Care Authority and a contracted entity for delivery of services to Medicaid members in which the Authority pays a fixed, per-member-per-month rate based on actuarial calculations;