As used in ORS 165.690, 165.692 and 165.694:
(1) �Claim for health care payment� means any request or demand for a health care payment, whether made in the form of a bill, claim form, cost report, invoice, electronic transmission or any other document. �Claim for health care payment� does not include any statement by a person on an application for coverage under a contract or certificate of health care coverage issued by an insurer, health care service contractor, health maintenance organization or other legal entity that is self-insured and provides health care benefits to its employees.
(2) �Health care payment� means money paid in compensation for the delivery of specified health care services, whether under a contract, certificate or policy of insurance, by a health care payor.
(3) �Health care payor� means:
(a) Any insurance company authorized to provide health insurance in this state;
(b) A health maintenance organization;
(c) A health care service contractor;
(d) Any legal entity that is self-insured and provides benefits for health care services to its employees;
(e) Any legal entity responsible for handling claims for health care services under a state or federal medical assistance program;
(f) The State of Oregon or any local government within this state that makes payments for health care services;
(g) Any insurer authorized under ORS chapter 731 to transact workers� compensation or casualty insurance in this state; or
(h) Any employer authorized under ORS chapter 656 to self-insure its workers� compensation risk.
(4) �Health care services� means any medical or remedial care or service, including supplies delivered in connection with the care or service, that is recognized under state law.
(5) �Person� means an individual, corporation, partnership or association that provides health care services or any other form of legal or business entity that provides health care services. [1995 c.496 §1; 2001 c.556 §1]
Section: Previous 165.667 165.669 165.670 165.671 165.673 165.675 165.680 165.690 165.692 165.694 165.696 165.698 165.800 165.803 165.805 NextLast modified: August 7, 2008