Health insurers definition

Health insurers means all persons, firms, corporations, or other organizations
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Health insurers means all persons, firms, corporations, or other organizations offering and assuring health services on a prepaid or primarily expense-incurred basis, including but not limited to policies of accident or sickness insurance, as defined by chapter 18 of this title, nonprofit hospital or medical service plans, whether organized under chapter 19 or 20 of this title or under any public law or by special act of the general assembly, health maintenance organizations, or any other entity which insures or reimburses for diagnostic, therapeutic, or preventive services to a determined population on the basis of a periodic premium. Provided, this chapter does not apply to insurance coverage providing benefits for:
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Health insurers means Aetna Life Insurance Company, Cigna Corporation, UnitedHealthcare Insurance Company, and WellPoint, Inc., as participants in this proceeding.
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Examples of Health insurers in a sentence

  • Health insurers shall establish reasonable policies and procedures for providers to conduct eligibility checks at the time services are provided.

  • Health insurers may include the reasonable cost of retroactive terminations into their filed rates.

  • Health insurers shall participate in a centralized registry for coverage information designated by the Commissioner.

  • Health insurers shall establish written standards and procedures to notify providers of all eligibility determinations electronically and telephonic at the time eligibility determination is requested by the provider.

  • Health insurers shall utilize a standardized appeal checklist approved by the Commissioner when informing providers of a timely filing denial and what needs to be submitted to appeal that denial.

  • Health insurers shall comply with all state and federal laws and regulations relating to requests for written clinical and medical record information from patients or providers.

  • Health insurers shall accept a provider appeal of a denial for failure to meet timely claim filing requirements so long as the claim is submitted to the correct Health Insurer within 180 days of the date of receipt by the provider of a denial from the initial, incorrect Health Insurer, provided that the initial claim was submitted to the incorrect Health Insurer within 180 days of the date of service.

  • Health insurers have just begun to invest in managed care activities.

  • Health insurers shall adopt policies for the most common preventive behavioral health screenings in primary care that are no more restrictive than current applicable federal law and regulations for preventive services.

  • Health insurers shall not impose a minimum attribution threshold for making care management PMPM or infrastructure payments to a Patient Centered Medical Home.


More Definitions of Health insurers

Health insurers means the following insurers who are participating in the legal proceedings for the rehabilitation of PTNA and ANIC: Aetna Life Insurance Company, Cigna Corporation, UnitedHealthcare Insurance Company, and WellPoint, Inc.
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Related to Health insurers

  • Health insurer means the same as that term is defined in Section 31A-22-615.5.

  • Health insurance means protection which provides payment of benefits for covered sickness or injury.

  • Health insurance carrier or "carrier" means any entity subject to the insurance

  • Health insurance issuer means an insurance company, or insurance organization (including a health

  • Health insurance plan means any health insurance policy or health benefit plan offered by a health insurer or a subcontractor of a health insurer, as well as Medicaid and any other public health care assistance program offered or administered by the State or by any subdivision or instrumentality of the State. The term includes vision care plans but does not include policies or plans providing coverage for a specified disease or other limited benefit coverage.

  • Health insurance coverage means benefits consisting of medical care (provided directly, through

  • Group health insurance coverage means in connection with a group health plan, health insurance

  • Accident and health insurance means contracts that incorporate morbidity risk and provide protection against economic loss resulting from accident, sickness, or medical conditions and as may be specified in the valuation manual.

  • Health Insurance Portability and Accountability Act means the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110 Stat. 1936, as amended.

  • Health information means any information or data except age or gender, whether oral or recorded in any form or medium, created by or derived from a health care provider or the consumer that relates to:

  • Credit accident and health insurance means insurance on a debtor to provide

  • Summary Health Information means information (a) that summarizes the claims history, claims expenses, or type of claims experienced by individuals for whom a plan sponsor had provided health benefits under a health plan; and (b) from which the information described at 42 CFR Section 164.514(b)(2)(i) has been deleted, except that the geographic information described in 42 CFR Section 164.514(b)(2)(i)(B) need only be aggregated to the level of a five-digit ZIP code.

  • HIPAA means the Health Insurance Portability and Accountability Act of 1996, as amended.

  • personal health information means, with respect to an individual, whether living or deceased:

  • Electronic Protected Health Information has the same meaning as the term “electronic protected health information” at 45 C.F.R. § 160.103, limited to Protected Health Information created or received by Business Associate from or on behalf of Covered Entity. For the convenience of the parties, Electronic Protected Health Information means Protected Health Information that is (i) transmitted by electronic media; (ii) maintained in electronic media.

  • Protected Health Information or “PHI” shall have the same meaning as the term “protected health information” in 45 C.F.R. § 160.103, and includes electronic PHI, as defined in 45 C.F.R. 160.103, limited to information created, maintained, transmitted or received by the Business Associate from or on behalf of the Covered Entity or from another Business Associate of the Covered Entity.