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

  • 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.

  • 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.

  • 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.

  • Commercial Payor and Medicare Part D Rebates The Company contracts with certain third-party payors, primarily pharmacy benefit managers (“PBMs”) and health plans (“Plans”), for the payment of rebates with respect to utilization of its product.

  • 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.

  • MISSION STATEMENT The mission of the Commercial Payor Relations (CPR) Committee is to be an advocate for HBMA membership by establishing meaningful relationships with commercial payors.

  • We define Reasonable Reimbursement to the dominant Commercial Payor Reimbursement at the treating Medical Provider.

  • 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.

  • When looking at payor mix, there was a slight increase in the Commercial Payor category.

  • 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 any private health insurance company.
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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, 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-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.

  • Applicable Insurance Regulatory Authority means, when used with respect to any Insurance Subsidiary, the insurance department or similar administrative authority or agency located in (x) the state or other jurisdiction in which such Insurance Subsidiary is domiciled or (y) to the extent asserting regulatory jurisdiction over such Insurance Subsidiary, the insurance department, authority or agency in each state or other jurisdiction in which such Insurance Subsidiary is licensed, and shall include any Federal insurance regulatory department, authority or agency that may be created in the future and that asserts regulatory jurisdiction over such Insurance Subsidiary.

  • Health care facility or "facility" means hospices licensed

  • Credit insurance means insurance offered in connection with an extension of credit that is limited to partially or wholly extinguishing that credit obligation.

  • Commercial Production means the operation of the Property or any portion thereof as a producing mine and the production of mineral products therefrom (excluding bulk sampling, pilot plant or test operations);

  • 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.

  • Regulated Insurance Company means any Subsidiary of the Borrower, whether now owned or hereafter acquired, that is authorized or admitted to carry on or transact Insurance Business in any jurisdiction and is regulated by any Applicable Insurance Regulatory Authority.

  • Limited line credit insurance producer means a person who sells, solicits, or negotiates one or more forms of limited line credit insurance coverage to an individual through a master, corporate, group, or individual policy.

  • Commercial Product means any such product as defined in FAR 2.101.

  • In-Orbit Insurance means, with respect to any Satellite (or, if the entire Satellite is not owned by the Issuer or any Restricted Subsidiary, as the case may be, the portion of the Satellite it owns or for which it has risk of loss), insurance (subject to a right of co-insurance in an amount up to $150.0 million) or other contractual arrangement providing for coverage against the risk of loss of or damage to such Satellite (or portion, as applicable) attaching upon the expiration of the launch insurance therefor (or, if launch insurance is not procured, upon the initial completion of in-orbit testing) and attaching, during the commercial in-orbit service of such Satellite (or portion, as applicable), upon the expiration of the immediately preceding corresponding policy or other contractual arrangement, as the case may be, subject to the terms and conditions set forth in this Indenture.

  • Commercial Service means water service provided by the water utility that the customer uses in the promotion of a business or business product that is a source of revenue or income to the customer or others using the premises.

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

  • Group long-term care insurance means a long-term care insurance policy which is delivered or issued for delivery in this State and issued to:

  • Insurance Regulatory Authority means, with respect to any Insurance Subsidiary, the insurance department or similar Governmental Authority charged with regulating insurance companies or insurance holding companies, in its jurisdiction of domicile and, to the extent that it has regulatory authority over such Insurance Subsidiary, in each other jurisdiction in which such Insurance Subsidiary conducts business or is licensed to conduct business.

  • National Flood Insurance Program means the program created by the U.S. Congress pursuant to the National Flood Insurance Act of 1968 and the Flood Disaster Protection Act of 1973, as revised by the National Flood Insurance Reform Act of 1994, that mandates the purchase of flood insurance to cover real property improvements located in Special Flood Hazard Areas in participating communities and provides protection to property owners through a Federal insurance program.

  • 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 facilities means buildings, structures, or equipment suitable and intended for, or incidental or ancillary to, use in providing health services, including, but not limited to, hospitals; hospital long-term care units; infirmaries; sanatoria; nursing homes; medical care facilities; outpatient clinics; ambulatory care facilities; surgical and diagnostic facilities; hospices; clinical laboratories; shared service facilities; laundries; meeting rooms; classrooms and other educational facilities; students', nurses', interns', or physicians' residences; administration buildings; facilities for use as or by health maintenance organizations; facilities for ambulance operations, advanced mobile emergency care services, and limited advanced mobile emergency care services; research facilities; facilities for the care of dependent children; maintenance, storage, and utility facilities; parking lots and structures; garages; office facilities not less than 80% of the net leasable space of which is intended for lease to or other use by direct providers of health care; facilities for the temporary lodging of outpatients or families of patients; residential facilities for use by the aged or disabled; and all necessary, useful, or related equipment, furnishings, and appurtenances and all lands necessary or convenient as sites for the health care facilities described in this subdivision.

  • Commercial plan means a subcontracting plan (including goals) that covers the offeror’s fiscal year and that applies to the entire production of commercial items sold by either the entire company or a portion thereof (e.g., division, plant, or product line).

  • 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.

  • Long-term care insurance means group insurance that is authorized by the retirement system for retirants, retirement allowance beneficiaries, and health insurance dependents, as that term is defined in section 91, to cover the costs of services provided to retirants, retirement allowance beneficiaries, and health insurance dependents, from nursing homes, assisted living facilities, home health care providers, adult day care providers, and other similar service providers.

  • Licensed financial institution means a financial institution issued a license under this act.

  • Specialty drug means a prescription drug that: