Part 7.

218 words·~1 min read·/nc/chapter-58/7-2

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Part 7. Contracts Between Health Benefit Plans and Health Care Providers.

§ 58-50-270. Definitions.

Unless the context clearly requires otherwise, the following definitions apply in this Part.

(1)"Amendment" - Any change to the terms of a contract, including terms incorporated by reference, that modifies fee schedules. A change required by federal or State law, rule, regulation, administrative hearing, or court order is not an amendment.

(2)"Contract" - An agreement between an insurer and a health care provider for the provision of health care services by the provider on a preferred or in-network basis.

(3)"Health benefit plan" - A policy, certificate, contract, or plan as defined in G.S. 58-3-167.

(3a)"Health care provider" - An individual who is licensed, certified, or otherwise authorized under Chapter 90 or Chapter 90B of the General Statutes or under the laws of another state to provide health care services in the ordinary course of business or practice of a profession or in an approved education or training program and a facility that is licensed under Chapter 131E or Chapter 122C of the General Statutes or is owned or operated by the State of North Carolina in which health care services are provided to patients.

(4)"Insurer" - An entity as defined in G.S. 58-3-227(a)(4). (2009-352, s. 1; 2009-487, s. 2(a).)