Terms Used In Kansas Statutes > Chapter 40 > Article 46 - Managed Care

• 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.
• Commissioner: means the Kansas commissioner of insurance;

  (b) "department" means the Kansas department of insurance; and

  (c) "health benefit plan" shall have the meaning ascribed to such term by subsection (1) of Kan. See Kansas Statutes 40-4622

• Contract: A legal written agreement that becomes binding when signed.
• 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.
• Emergency medical condition: means the sudden and, at the time, unexpected onset of a health condition that requires immediate medical attention, where failure to provide medical attention would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part, or would place the person's health in serious jeopardy. See Kansas Statutes 40-4602
• Emergency services: means ambulance services and health care items and services furnished or required to evaluate and treat an emergency medical condition, as directed or ordered by a physician. See Kansas Statutes 40-4602
• Fraud: Intentional deception resulting in injury to another.
• Health benefit plan: means any hospital or medical expense policy, health, hospital or medical service corporation contract, a plan provided by a municipal group-funded pool, a policy or agreement entered into by a health insurer or a health maintenance organization contract offered by an employer or any certificate issued under any such policies, contracts or plans. See Kansas Statutes 40-4602
• Health insurer: means any insurance company, nonprofit medical and hospital service corporation, municipal group-funded pool, fraternal benefit society, health maintenance organization, or any other entity which offers a health benefit plan subject to the Kansas Statutes Annotated. See Kansas Statutes 40-4602
• Insured: means a person who is covered by a health benefit plan. See Kansas Statutes 40-4602
• Participating provider: means a provider who, under a contract with the health insurer or with its contractor or subcontractor, has agreed to provide one or more health care services to insureds with an expectation of receiving payment, other than coinsurance, copayments or deductibles, directly or indirectly from the health insurer. See Kansas Statutes 40-4602
• Physician: means a person licensed by the state board of healing arts to practice medicine and surgery. See Kansas Statutes 40-4602
• Provider: means a physician, hospital or other person which is licensed, accredited or certified to perform specified health care services. See Kansas Statutes 40-4602
• Provider network: means those participating providers who have entered into a contract or agreement with a health insurer to provide items or health care services to individuals covered by a health benefit plan offered by such health insurer. See Kansas Statutes 40-4602
• State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Kansas Statutes 77-201