Commercial Payor definition

Commercial Payor means any entity which arranges for payment or reimbursement of expenses on account of Medical Services, including the following types of entities:
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Commercial Payor means, each Payor that is not a Governmental Entity Payor.
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Commercial Payor means any private insurer, managed care plan, health benefit plan, health maintenance organization, preferred provider organization, employer-sponsored health plan or any other Person or entity that maintains a similar payor program.
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Examples of Commercial Payor in a sentence

  • Sellers shall be solely responsible for all out of pocket costs and expenses arising out of or incurred in connection with such PI Audit appeals or Commercial Payor Audits or administrative actions, including any responses required in connection therewith.

  • Except as set forth on Section 4.22(c) of the Company Disclosure Schedule, to the Company’s Knowledge, no Commercial Payor or Vendor disclosed on Section 4.22(a) of the Company Disclosure Schedule may terminate or materially alter its Contracts with the Company or its Subsidiaries as a result of the transactions contemplated hereby.

  • For the avoidance of doubt, in no event shall Purchaser be responsible for any liabilities arising out of a PI Audit or Commercial Payor Audit with respect to patients with dates of service prior to the Closing Date, all of which liabilities are Retained Liabilities hereunder.

  • Except as set forth on Section 4.22(b) of the Company Disclosure Schedule, no Commercial Payor or Vendor disclosed on Section 4.22(a) of the Company Disclosure Schedule has, during the last twelve (12) months, cancelled, terminated or, to the Knowledge of the Company, sent any written notice or threat of its intention to cancel or otherwise terminate any of its Contracts with the Company or its Subsidiaries.

  • EHR's comprehensive solutions include Medicare and Medicaid Compliance Management, Medicare and Medicaid Denials and Appeals Management (including RAC, QIO and MAC denials), and Commercial Payor Denials and Appeals Management.

  • Each Acquired Group Company has used commercially reasonable efforts to collect all co-payments, deductibles and other applicable patient financial responsibilities in the Ordinary Course of Business (taking into account all COVID-19 Actions), except as permitted by applicable Law and applicable Contracts for Commercial Payor Programs and other requirements.

  • All billing and collection procedures of, and claims submitted by the Acquired Group Companies with respect to all Governmental Health Programs and Commercial Payor Programs have been in compliance in all material respects with all regulatory laws, regulations, and policies of, and Payor agreements with such Governmental Health Programs and Commercial Payor Programs.

  • No such Commercial Payor has terminated or materially and adversely altered its business relationship or provided written notice of its intention to terminate or materially and adversely alter its business relationship, with any Company.


More Definitions of Commercial Payor

Commercial Payor means, each Payor that is not a Governmental Entity Payor. “[*]” means, [*] (as such term is defined in the Certificate of Incorporation).
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Related to Commercial Payor

  • Medicaid means that government-sponsored entitlement program under Title XIX, P.L. 89-97 of the Social Security Act, which provides federal grants to states for medical assistance based on specific eligibility criteria, as set forth on Section 1396, et seq. of Title 42 of the United States Code.

  • 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.

  • TRICARE means the program administered pursuant to 10 U.S.C. Section 1071 et. seq), Sections 1320a-7 and 1320a-7a of Title 42 of the United States Code and the regulations promulgated pursuant to such statutes.

  • Health-care-insurance receivable means an interest in or claim under a policy of insurance which is a right to payment of a monetary obligation for health-care goods or services provided.

  • Federal Flood Insurance means federally backed Flood Insurance available under the National Flood Insurance Program to owners of real property improvements located in Special Flood Hazard Areas in a community participating in the National Flood Insurance Program.