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 Account Debtor that is a natural person.
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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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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.

  • 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.

  • 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.

  • If each and every Private Payor identified pursuant to Section 13.01(C)(1) participate in the PLRP administered by the Lien Resolution Administrator or no Private Payors are identified, then the PLRP shall dictate the amount to be withheld in the Qualified Settlement Fund, but in no event will that holdback exceed 30% of the gross settlement proceeds.

  • 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.

  • 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.

  • 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.

  • Each Program Participant and his or 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 Olmesartan Products from the time the Program Participant alleges he or she first suffered injury from the alleged use of Olmesartan Products through the Execution Date.

  • Each Group Member will file all material applicable Government Reimbursement Program and Private Payor Arrangement cost reports in a timely and complete manner.

  • At any time the CIN may require the existing Participant to submit written evidence of his/her ability to participate in Federal and Private Payor programs.


More Definitions of Private Payor

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, but shall not include a Government Reimbursement Program.
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Private Payor means a Resident Payor.
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Private Payor means a Person other than an Insurer or Governmental Entity.
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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

  • private party means a party that enters into a project agreement with a contracting authority and is responsible for undertaking a project on behalf of the contracting authority under this Act;

  • 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.

  • Private partner means any entity that is a partner in a public-private partnership other than:

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

  • private hospital means a hospital that is not a public hospital;

  • public hospital means a governmental entity of a political subdivision of the state of Iowa that is authorized by legislative authority. For purposes of this subrule, a “public hospital” must also meet the requirements of Iowa Code section 249J.3. Under Iowa Code section 249J.3, a “public hospital” must be licensed pursuant to Iowa Code chapter 135B and governed pursuant to Iowa Code chapter 145A (merged hospitals), Iowa Code chapter 347 (county hospitals), Iowa Code chapter 347A (county hospitals payable from revenue), or Iowa Code chapter 392 (creation by city of a hospital or health care facility). For the purposes of this definition, “public hospital” does not include a hospital or medical care facility that is funded, operated, or administered by the Iowa department of human services, Iowa department of corrections, or board of regents, or the Iowa Veterans Home.

  • Private Hire Vehicle means a licensed vehicle constructed or adapted to seat fewer than nine passengers, other than a hackney carriage or public service vehicle, which is provided for hire with the services of a driver for the purpose of carrying passengers

  • 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 or authorized 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.

  • 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.

  • 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, (a) all Federal statues (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 statues succeeding thereto and (b) 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 CMS, the OIG, 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.