WAC 182-500-0015 Medical assistance definitions -- B.
Effective April 1, 2016
"Behavioral health organization" means a single- or multi-county authority or other entity operating as a prepaid health plan with which the medicaid agency or the agency's designee contracts for the delivery of community outpatient and inpatient mental health and substance use disorder services in a defined geographic area.
"Benefit package" means the set of health care service categories included in a client's health care program. See WAC 182-501-0060.
"Benefit period" means the time period used to determine whether medicare can pay for covered Part A services. A benefit period begins the first day a beneficiary receives inpatient hospital or extended care services from a qualified provider. The benefit period ends when the beneficiary has not been an inpatient of a hospital or other facility primarily providing skilled nursing or rehabilitation services for sixty consecutive days. There is no limit to the number of benefit periods a beneficiary may receive. Benefit period also means a "spell of illness" for medicare payments.
"Billing instructions" means provider guides. See WAC 182-500-0085.
"Blind" is a category of medical program eligibility that requires:
- A central visual acuity of 20/200 or less in the better eye with the use of a correcting lens; or
- A field of vision limitation so the widest diameter of the visual field subtends an angle no greater than twenty degrees from central.
"By report (BR)" means a method of payment in which the agency or the agency's designee determines the amount it will pay for a service when the rate for that service is not included in the agency's published fee schedules. The provider must submit a report which describes the nature, extent, time, effort and equipment necessary to deliver the service.