Terms Used In Louisiana Revised Statutes > Title 17 > Chapter 1 > Part VII-A - Summer Enrichment Programs

• Claim: means a request by a health care provider for payment from a health insurance issuer. See Louisiana Revised Statutes 22:1831
• Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1831
• coverage: means benefits consisting of health care services provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as health care services under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization agreement, or health maintenance organization contract offered by a health insurance issuer. See Louisiana Revised Statutes 22:1831
• Escrow: Money given to a third party to be held for payment until certain conditions are met.
• Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
• Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
• Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
• Health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1831
• insured: means an individual who is enrolled or insured by a health insurance issuer for health insurance coverage. See Louisiana Revised Statutes 22:1831
• issuer: means any entity that offers health insurance coverage through a policy, contract,  or certificate of insurance subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1831
• Joint resolution: A legislative measure which requires the approval of both chambers.
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Paid: means the transfer by the health insurance issuer or its agent of the amount of the health insurance issuer liability on either of the following dates:

  (a)  The date of mailing of a check via the United States Postal Service or a commercial carrier to the correct address. See Louisiana Revised Statutes 22:1831

• provider: means :

  (a)  A physician or other health care practitioner licensed, certified, registered, or otherwise authorized to perform specified health care services consistent with state law. See Louisiana Revised Statutes 22:1831

• Quorum: The number of legislators that must be present to do business.
• receipt: means :

  (a)  For a nonelectronic claim:

  (i)  For a claim mailed via the United States Postal Service for which no return receipt is requested, the physical receipt of the claim by the health insurance issuer or its agent designated for the receipt of claims at the correct claims address, as documented in accordance with claims filing procedures filed by the health insurance issuer with the department. See Louisiana Revised Statutes 22:1831