Private health insurer definition

Private health insurer means any organization that is not a govern- mental unit that offers health insur- ance, including nongovernmental orga- nizations administering a health insur- ance plan under Medicare Advantage (Part C of Title XVIII of the Social Se- curity Act, 42 U.S.C. 1395w–21 through 1395w–29). For purposes of § 1.501(r)–5(b), medical assistance provided through a contract between the state and a Med- icaid managed care organization or a prepaid inpatient health plan is not considered to be a reimbursement from or a claim allowed by a private health insurer.
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Private health insurer means anyorganization that offers insurance for medical care that is not a governmental unit described in section 170(c)(1). For purposes of § 1.501(r)–5(b), claims paid under Medicare Advantage (Part C of Title XVIII of the Social Security Act) are treated as claims paid by a private health insurer.
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Private health insurer means a body corporate registered under
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Examples of Private health insurer in a sentence

  • Private health insurer contracts As the financial position for health insurers becomes tighter, they continue to look for ways to reduce their costs.

  • Figure 13: Change in private health insurance exclusionary and non-exclusionary policies (20012021)27 Private health insurer expenses Private health insurers will generally aim to set premium levels to cover the expected costs of benefits (that is, payments made on behalf of insured members for admitted hospital costs and doctors’ fees), plus the fund’s management costs.

  • Private health insurer companies offer health plans based on a standardized benefits package, which is defined by the government.

  • Private health insurer perceptions were also sought from the Australian Health Insurance Association, the Health Insurance Restricted Membership Association of Australian (HIRMAA), and the Australian Health Services Alliance.The full sample can be found at Appendix B, and the response rate which was achieved is detailed in Chapter 3.


More Definitions of Private health insurer

Private health insurer means a company that provides health insurance;
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Private health insurer means anyorganization that is not a governmental unit that offers health insurance, including nongovernmental organizations administering a health insurance plan under Medicare Advantage (Part C of Title XVIII of the Social Security Act, 42 U.S.C. 1395w–21 through 1395w–29). For purposes of§ 1.501(r)–5(b), medical assistance provided through a contract between the state and a Medicaid managed care organization or a prepaid inpatient health plan is not considered to be a reimbursement from or a claim allowed by a private health insurer.
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Private health insurer means a body that is registered under Division 3 of Part 2 of thePrivate Health Insurance (Prudential Supervision) Act 2015 .
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Private health insurer means any organization that offers insurance for med- ical care that is not a governmental unit described in section 170(c)(1). For pur- poses of §1.501(r)–5(b), claims paid under Medicare Advantage (Part C of Title XVIII of the Social Security Act) are treated as claims paid by a private health insurer.
Sample 1
Private health insurer means any organization that is not a governmental unit that offers health insurance, including nongovernmental organizations adminis- tering a health insurance plan under Medi- care Advantage (Part C of Title XVIII of the Social Security Act, 42 U.S.C. 1395w–21 through 1395w–29). For pur- poses of § 1.501(r)–5(b), medical assis- tance provided through a contract between the state and a Medicaid managed care organization or a prepaid inpatient health plan is not considered to be a reimburse- ment from or a claim allowed by a private health insurer.
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Private health insurer means a body that is registered under Division 3 of Part 2.
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Related to Private health insurer

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

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

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

  • Health insurance exchange means an exchange as defined in 45 C.F.R. Sec. 155.20.

  • 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 policy means a policy that provides specified benefits for hospital and/or general treatment and meets all requirements under section 63-10 of the Private Health Insurance Act 2007.

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

  • health institution means an organisation whose primary purpose is the care or treatment of patients or the promotion of public health;

  • 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.

  • 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.

  • 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.

  • Health information exchange or “HIE” shall mean the Common HIE Resources and infrastructure made available to Participants by CRISP for Permitted Purposes, as defined in Section 3.02 of the Terms and Conditions, subject to the terms of the Agreement. Common HIE Resources shall not include the technological infrastructure provided by the Direct Technology Provider for the Direct Service.

  • 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:

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

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

  • Electronic Protected Health Information means Protected Health Information that is maintained in or transmitted by electronic media.

  • 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.

  • Rural health clinic means a rural health clinic as defined under section 1861 of part C of title XVIII of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1395x, and certified to participate in medicaid and medicare.

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

  • Individual health insurance coverage means health insurance coverage offered to individuals in the

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

  • Electronic Protected Health Information (EPHI) means Protected Health Information that is transmitted by electronic media or maintained in any medium described in the definition of electronic media at 45 CFR 160.103.

  • Insider Trading Regulations means the Securities and Exchange Board of India (Prohibition of Insider Trading) Regulations, 2015, as amended from time to time.

  • HITECH means the Health Information Technology for Economic and Clinical Health Act.

  • Data Protection Regulation means Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 20161 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation);

  • Individually Identifiable Health Information means information that is a subset of health information, including demographic information collected from an individual, and: (a) is created or received by a health care provider, health plan, employer, or health care clearinghouse; (b) relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and (c) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual.