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Primary Payor definition

Primary Payor means the plan that will determine the medical benefits which will be payable to you first.
Primary Payor means (i) each Obligor referred to in clauses (A), (B), (E), (F) and (G) of the definition of “Obligor” contained in this Section 1.1, (ii) collectively, all Obligors of the type referred to in clause (C) of the definition of “Obligor” contained in this Section 1.1 and (iii) collectively, all Obligors of the type referred to in clause (D) of the definition of “Obligor” contained in this Section 1.1.
Primary Payor means the plan that will determine the mental health and substance abuse benefits that will be payable to you first.

Examples of Primary Payor in a sentence

  • How to Determine the Primary Payor Primary coverage is determined in accord with applicable law and the member’s benefit plan.

  • Physician payments = Place the total Primary Payor Payments for the procedure or service indicated in fields 11 and 8.

  • PROCEDURE: Facility payments = Place total Primary Payor Payments as stated in the definition above.

  • REFERENCESSection 412 (h) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 350a(h))WRO Policy Memo 804-Q: Medicaid Primary Payor for Exempt Infant Formulas and Medical Foods7CFR Part 246: Revisions in the WIC Food Packages: Final Rule CONTRACT BRAND INFANT FORMULAS POLICYContract brand iron-fortified milk-based and soy-based, infant formulas will be issued to all infants unless there is medical documentation for an exempt formula or a WIC-eligible nutritional.

  • If Sulzer denies any claim(s) for identified Covered Revisions Surgeries or disputes any other information supplied by a Settling Health Plan including the plan's status as a Primary Payor or the amounts incurred by any Secondary Payor, it will do so no later than forty-five (45) days from its receipt of the Revision Report, unless an extension of time is agreed to between the parties.

  • REFERENCESSection 412 (h) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 350a(h))WRO Policy Memo 804-Q: Medicaid Primary Payor for Exempt Infant Formulas and Medical Foods7CFR Part 246: Revisions in the WIC Food Packages: Final Rule Contract Brand Infant Formulas POLICYContract brand iron-fortified milk-based and soy-based, infant formulas will be issued to all infants unless there is medical documentation for an exempt formula or a WIC-eligible nutritional.

  • Discovered Primary Payor Health Insurance Information ( if applicable)Client Medicaid Number Insurance Company Name Insurance Company AddressStreet City State ZipCode List below any family members that are on the Health Insurance Policy:1.4.2.5.3.6. You must provide written, detailed information about your self disclosure.

  • A blank will result in non-acceptance of the report.Required Supporting Documentation: N/AC.3 Medicaid IDC.4 Primary Payor - Refers to the insurance company that pays first on claims submitted by suppliers and providers.

  • Resident chose another NFh. InsuranceValidation: This should only be filled in if the admitted column was marked ´1R´Required Supporting Documentation: N/AB.9 Primary Payor - Refers to the insurance company that pays first on claims submitted by suppliers and providers.

  • CLAIMS 15Claims Submission 15Coordination of Benefits 15Determination of Primary Payor 15Coordination of Benefits Claims Submission 16Refunds and Recovery of Overpayments 17Non-Payment of Claims 17VI I .


More Definitions of Primary Payor

Primary Payor means the first category of major payor categories which receives the bill for a patient stay.
Primary Payor means (i) each Obligor referred to in clauses (A), (B), (E), (F) and (G) of the definition of "Obligor" contained in this Section 1.1, (ii) collectively, all Obligors of the type referred to in clause (C) of the definition of "Obligor" contained in this Section 1.1 and (iii) collectively, all Obligors of the type referred to in clause (D) of the definition of "Obligor" contained in this Section 1.1.
Primary Payor means all cases in which neither the Medicare Program nor any other health insurer is the Affected Product Recipient's primary health insurer. This payment will be made as designated by the Settling Health Plan's legal counsel no later than sixty (60) days after Sulzer's receipt of the Revision Report. As to those claims where thexx xx xx dispute, the Revision Report or supplemental Revision Report will serve as Sulzer's payment instructions to the Trustee pursuant to a Sulzer appxxxxx xxird party payor settlement as provided in the Class Action Settlement.

Related to Primary Payor

  • 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.

  • 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.

  • 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.

  • 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 Levy Surcharge means an extra charge payable by high income earners beyond the standard Medicare Levy if they do not have qualifying private hospital insurance coverage. This charge is assessed as part of an individual or family’s annual tax return.

  • 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.

  • 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.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Health care insurer means a disability insurer, group

  • 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.

  • 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.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Third-party payer means an entity that is, by

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

  • Primary care provider (PCP) means, for the purpose of this plan, professional providers that are family practitioners, internists, and pediatricians. For the purpose of this plan, gynecologists, obstetricians, nurse practitioners, and physician assistants may be credentialed as PCPs. To find a PCP or check that your provider is a PCP, please use the “Find a Doctor” tool on our website or call Customer Service.

  • 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.

  • 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 services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • primary carer means the person who has responsibility for the care of the Child. Only one person can be the Child’s Primary Carer on a particular day.

  • 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, TRICARE and similar or successor programs with or for the benefit of any Governmental Authority.

  • Child Care Program means a person or business that offers child care.

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • 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:

  • Primary care-giver means a person who assumes the principal role of providing care and attention to a child.

  • Indian Health Care Provider means a health care program

  • 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.

  • Health care facility or "facility" means hospices licensed