Participating provider shall mean a provider who, under an express or implied contract with the health maintenance organization or with its contractor or subcontractor, has agreed to provide health care services to enrollees with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the health maintenance organization.

Terms Used In Nebraska Statutes 44-32,110

  • Contract: A legal written agreement that becomes binding when signed.
  • Copayment: shall mean an amount an enrollee must pay in order to receive a specific service which is not fully prepaid. See Nebraska Statutes 44-3296
  • Deductible: shall mean the amount an enrollee is responsible to pay out of pocket before the health maintenance organization begins to pay the costs associated with treatment. See Nebraska Statutes 44-3297
  • Health maintenance organization: shall mean any person who undertakes to provide or arrange for the delivery of basic health care services to enrollees on a prepaid basis except for enrollee responsibility for copayments or deductibles. See Nebraska Statutes 44-32,105
  • Participating provider: shall mean a provider who, under an express or implied contract with the health maintenance organization or with its contractor or subcontractor, has agreed to provide health care services to enrollees with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the health maintenance organization. See Nebraska Statutes 44-32,110
  • Provider: shall mean any physician, hospital, or other person licensed or otherwise authorized to furnish health care services. See Nebraska Statutes 44-32,111
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