Private Payor definition

Private Payor means any insurance company, health maintenance organization, preferred provider organization or similar entity that is obligated to make payments for goods or services provided to a patient, but shall not include a Government Reimbursement Program.
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Private Payor means any insurance company, health maintenance organization, professional provider organization or similar entity that is obligated to make payments for goods or services provided to a patient, other than a governmental entity.
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Private Payor means any Account Debtor that is a natural person.
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Examples of Private Payor in a sentence

  • To the actual knowledge of the Responsible Officers of the Borrower, there is no threatened termination of any participation agreements under any Private Payor Arrangements to which any Credit Party is a party and which termination would reasonably be expected to have a Material Adverse Effect.

  • The funds withheld in the Qualified Settlement Fund may be paid from the Qualified Settlement Fund directly to the Governmental and/or Private Payor at the direction of the Program Participant to the extent of such Payor’s interests.

  • Each Program Participant and her counsel agree to identify every Private Payor that may have made any payments on behalf of such Program Participant in any way related to such Program Participant’s injury from the alleged use of DCOCs from the time the Program Participant alleges she first suffered injury from the alleged use of DCOCs through the Execution Date.

  • Claimant and Claimant’s Counsel agree to identify every Private Payor that may have made any payments on behalf of Claimants in any way related to Claimant’s alleged use of a DCOC from the time Claimant alleges she first suffered injury from the alleged use of a DCOC through the date the SA is fully executed.

  • For details, see CMS Announcement “Medicare Will Use Private Payor Prices to Set Payment Rates for Clinical Diagnostic Laboratory Tests Starting in 2018,” at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press- releases/2016-Press-releases-items/2016-06-17.html.

  • Option 6: If a Claimant did not have a Private Payor or governmental benefits that paid for her treatment, she shall provide an affidavit stating so.

  • It should be stressed, however, that the assumption of a homoscedastic measurement error is implicitly made by all studies that analyze changes in inequality over time.

  • Provider KY, OH and IN HIE, Hospitals, Nursing Homes Private Payor: Aetna and UnitedHealth Group Aetna's iTriagea helps users figure out what condition they might have and, using their device's GPS capabilities, points them in the direction of appropriate medical care.

  • For details, see CMS Announcement “Medicare Will Use Private Payor Prices to Set Payment Rates for Clinical Diagnostic Laboratory Tests Starting in 2018,” June 17, 2016, at https://www.cms.gov/newsroom/press-releases/medicare-will- use-private-payor-prices-set-payment-rates-clinical-diagnostic-laboratory-tests and CMS, “PAMA Regulations,” at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/PAMA-Regulations.html.

  • The funds withheld in the Qualified Settlement Fund may be paid from the Qualified Settlement Fund directly to the Lien Resolution Administrator’s trust for payment to the Governmental and/or Private Payor to the extent of such Payor’s interests.


More Definitions of Private Payor

Private Payor means a Resident Payor.
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Private Payor means an individual or insurance company responsible for the payment of services. Third-party govern- ment payor programs are not considered private payors.
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Private Payor means, individually and collectively as the context requires, (a) Insurance Payor and (b) Resident Payor.
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Private Payor means all non-Governmental Payors, including private managed care organizations, health maintenance organizations, MA organizations, self-insured health plans, preferred provider organizations, and workers’ compensation insurance plans, customers and individuals.
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Related to Private Payor

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Third Party Payor means Medicare, Medicaid, TRICARE, and other state or federal health care program, Blue Cross and/or Blue Shield, private insurers, managed care plans and any other Person or entity which presently or in the future maintains Third Party Payor Programs.

  • Federal Health Care Program means any “federal health care program” as defined in 42 U.S.C. § 1320a-7b(f), including Medicare, state Medicaid programs, state CHIP programs, the Veterans Administration, TRICARE and similar or successor programs with or for the benefit of any Governmental Authority, and in each case any third party payor administering such programs.

  • Medicare benefit means the Medicare benefit payable within the meaning of Part II of the Health Insurance Act 1973 with respect to a professional service.

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Home Health Care Agency means an agency or organization which provides a program of home health care and which:

  • Medicare Provider Agreement means an agreement entered into between CMS or other such entity administering the Medicare program on behalf of CMS, and a health care provider or supplier under which the health care provider or supplier agrees to provide items and services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Third Party Payors means Medicare, Medicaid, CHAMPUS, Blue Cross and/or Blue Shield, private insurers and any other Person which presently or in the future maintains Third Party Payor Programs.

  • TRICARE means, collectively, a program of medical benefits covering former and active members of the uniformed services and certain of their dependents, financed and administered by the United States Departments of Defense, Health and Human Services and Transportation, and all laws applicable to such programs.

  • Health care practitioner means an individual licensed

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Advance health care directive means a power of attorney for health care or a record signed by a prospective donor containing the prospective donor's direction concerning a health care decision for the prospective donor.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Medicare means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.

  • Medicare Advantage The Medicare managed care options that are authorized under Title XVIII as specified at Part C and 42 C.F.R. § 422.

  • Medicaid means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of Title XIX of the Social Security Act, codified at 42 U.S.C. 1396 et seq.

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Basic health care services means in and out-of-area emergency services, inpatient hospital and

  • Medicare Regulations means, collectively, all federal statutes (whether set forth in Title XVIII of the Social Security Act or elsewhere) affecting the health insurance program for the aged and disabled established by Title XVIII of the Social Security Act and any statutes succeeding thereto; together with all applicable provisions of all rules, regulations, manuals and orders and administrative, reimbursement and other guidelines having the force of law of all Governmental Authorities (including without limitation, Health and Human Services ("HHS"), HCFA, the Office of the Inspector General for HHS, or any Person succeeding to the functions of any of the foregoing) promulgated pursuant to or in connection with any of the foregoing having the force of law, as each may be amended, supplemented or otherwise modified from time to time.

  • Payor means a trustee, insurer, business entity, employer, government, governmental subdivision or agency, or other person authorized or obligated by law or a governing instrument to make payments.

  • Third Party Payor Programs means all third party payor programs in which Tenant presently or in the future may participate, including, without limitation, Medicare, Medicaid, CHAMPUS, Blue Cross and/or Blue Shield, Managed Care Plans, other private insurance programs and employee assistance programs.

  • Health Care Authority or “HCA” means the Washington State Health Care Authority, any division, section, office, unit or other entity of HCA, or any of the officers or other officials lawfully representing HCA.

  • Affordable Care Act means the Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education Reconciliation Act (HCERA).

  • Health care entity means any health care provider, health plan or health care clearinghouse.

  • Public health emergency means an emergency with respect to COVID–19 declared by a Federal, State, or local authority.