23 Miss. Code. R. 306-1.1 - Definitions
The Division of Medicaid defines:
A. Third party as any individual, entity or
program that is, or maybe, liable to pay all, or part of the expenditures for
medical assistance furnished under the State Plan.
B. Cost Avoidance as a method of avoiding
payment of Medicaid claims when other insurance resources are available to the
Medicaid beneficiary.
C. Pay and
Chase method as reimbursing the provider for a specific covered service and
pursuing recovery of the payment from a third party source.
D. Casualty Cases as claims that involve the
treatment of injuries arising out of vehicular collision, industrial accident,
product liability, malpractice cases, etc. in which collection from the third
party may be contingent upon legal action.
E. Preferred provider organization (PPO) as a
medical care arrangement in which medical professionals and facilities provide
services to subscribed beneficiaries at reduced rates. PPO medical and
healthcare providers are called preferred providers.
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No prior version found.