|§ 27-3A-1||Short title|
|§ 27-3A-4||Duties of utilization review agents|
|§ 27-3A-5||Standards for utilization review agents|
|§ 27-3A-6||Violations of chapter by utilization review agent|
Terms Used In Alabama Code > Title 27 > Chapter 3A
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- circuit: means judicial circuit. See Alabama Code 1-1-1
- Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
- department: The Alabama Department of Public Health. See Alabama Code 27-3A-3
- enrollee: An individual who has contracted for or who participates in coverage under an insurance policy, a health maintenance organization contract, a health service corporation contract, an employee welfare benefit plan, a hospital or medical services plan, or any other benefit program providing payment, reimbursement, or indemnification for health care costs for the individual or the eligible dependents of the individual. See Alabama Code 27-3A-3
- Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
- Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
- Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
- provider: A health care provider duly licensed or certified by the State of Alabama. See Alabama Code 27-3A-3
- Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
- UTILIZATION REVIEW: A system for prospective and concurrent review of the necessity and appropriateness in the allocation of health care resources and services given or proposed to be given to an individual within this state. See Alabama Code 27-3A-3
- UTILIZATION REVIEW AGENT: Any person or entity, including the State of Alabama, performing a utilization review, except the following:
a. See Alabama Code 27-3A-3