§ 22:1151 For the purposes of this Subpart, the following words and phrases shall be defined as follows:
§ 22:1152 Qualification and regulation of dental service contractors
§ 22:1153 Additional regulations
§ 22:1154 Freedom of choice of dentist in health plans
§ 22:1155 A.(1) A dental service contractor or a contract of dental insurance shall establish and maintain appeal procedures for any claim by a dentist or a subscriber that is denied based upo
§ 22:1156 Dental reimbursement or payments
§ 22:1157 A. As used in this Section, the following definitions shall apply:
§ 22:1157.1 A.(1) A dental service contractor shall not systematically downcode with the intent to deny reimbursement otherwise due to a dentist or other healthcare provider.

Terms Used In Louisiana Revised Statutes > Title 22 > Chapter 4 > Part III > Subpart G - Dental Service Contractors

  • Acquittal:
    1. Judgement that a criminal defendant has not been proved guilty beyond a reasonable doubt.
    2. A verdict of "not guilty."
     
  • 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.
  • Arrest: Taking physical custody of a person by lawful authority.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Chief judge: The judge who has primary responsibility for the administration of a court but also decides cases; chief judges are determined by seniority.
  • Civil forfeiture: The loss of ownership of property used to conduct illegal activity.
  • Contract: A legal written agreement that becomes binding when signed.
  • Conviction: A judgement of guilt against a criminal defendant.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • criminal street gang: means any ongoing organization, association, or group of three or more persons, whether formal or informal, which has as one of its primary activities the commission of one or more of the criminal acts enumerated in Paragraphs (1) through (13) of Subsection B of this Section or which has a common name or common identifying sign or symbol, whose members individually or collectively engage in or have engaged in a pattern of criminal gang activity. See Louisiana Revised Statutes 15:1404
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Dependent: A person dependent for support upon another.
  • Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
  • Electronic funds transfer: The transfer of money between accounts by consumer electronic systems-such as automated teller machines (ATMs) and electronic payment of bills-rather than by check or cash. (Wire transfers, checks, drafts, and paper instruments do not fall into this category.) Source: OCC
  • Enrolled bill: The final copy of a bill or joint resolution which has passed both chambers in identical form. It is printed on parchment paper, signed by appropriate officials, and submitted to the President/Governor for signature.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • pattern of criminal gang activity: means the commission or attempted commission of two or more of the following offenses, provided that the offenses occurred within a three-year period, and the offenses are committed on separate occasions or by two or more persons:

    (1)  Aggravated battery or second degree battery as defined in La. See Louisiana Revised Statutes 15:1404

  • person: includes a body of persons, whether incorporated or not. See Louisiana Revised Statutes 1:10
  • Preliminary hearing: A hearing where the judge decides whether there is enough evidence to make the defendant have a trial.
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • Service of process: The service of writs or summonses to the appropriate party.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Venue: The geographical location in which a case is tried.