Terms Used In Nebraska Statutes 44-6838

• Covered person: means a person on whose behalf an insurer is obligated to pay health care expense benefits or provide health care services. See Nebraska Statutes 44-6836
• Emergency medical condition: means a medical or behavioral condition, the onset of which is sudden, that manifests itself by symptoms of sufficient severity, including, but not limited to, severe pain, that a prudent layperson, possessing an average knowledge of medicine and health, could reasonably expect the absence of immediate medical attention to result in (1) placing the health of the person afflicted with such condition in serious jeopardy or, in the case of a behavioral condition, placing the health of such persons or others in serious jeopardy, (2) serious impairment to such person's bodily functions, (3) serious impairment of any bodily organ or part of such person, or (4) serious disfigurement of such person. See Nebraska Statutes 44-6837
• Emergency services: means health care services medically necessary to screen and stabilize a covered person in connection with an emergency medical condition. See Nebraska Statutes 44-6838
• Medically necessary: means a health care service that a health care provider, exercising his or her prudent clinical judgment, would provide to a covered person for the purpose of evaluating, diagnosing, or treating an illness, an injury, or a disease, or its symptoms, and that is in accordance with the generally accepted standards of medical practice. See Nebraska Statutes 44-6845