§ 46:460.70 In accordance with the provisions of R.S. 46:442, the department shall not limit the period within which a provider may submit a claim for payment for a covered service rendered to a
§ 46:460.71 A. Any claim payment to a provider by a managed care organization or by a fiscal agent or intermediary of the managed care organization shall be accompanied by an itemized accounting
§ 46:460.72 A. Each Medicaid managed care organization shall comply with the following notice provisions regarding contracted provider status and ability to begin providing services and submitti
§ 46:460.73 A.(1) Each Medicaid managed care organization shall be responsible for ensuring that any provider it contracts with or enrolls into its network has attained and satisfies all Medicai
§ 46:460.74 A. The prior authorization requirements of the department and each managed care organization, including prior authorization requirements applicable in the Medicaid pharmacy program,
§ 46:460.75 A. If a healthcare provider submits a request, either orally or in writing, to a managed care organization during the time prescribed by state law or regulation in which a managed ca
§ 46:460.76 A. A managed care organization or a contractor, assignee, agent, or entity acting on the behalf of a managed care organization shall be prohibited from requiring any enrolled provide

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Terms Used In Louisiana Revised Statutes > Title 46 > Chapter 3 > Part XIII > Subpart C - Claim Filing and Payment

  • 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.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Certificate of origin: means a document establishing the initial chain of ownership, such as a manufacturer's certificate of origin (MCO) or statement of origin (MSO), or an importer's certificate of origin (ICO) or statement of origin (ISO), or a builder's certification (Form CG-1261, under 46 C. See Louisiana Revised Statutes 34:852.2
  • Contract: A legal written agreement that becomes binding when signed.
  • Dealer: means any person who engages wholly or in part in the business of buying, selling, or exchanging for value new or used vessels or outboard motors, or both, either outright or on conditional sale, bailment, lease, chattel mortgage, or otherwise. See Louisiana Revised Statutes 34:852.2
  • Decedent: A deceased person.
  • Dental coordinated care network: means a managed care organization or prepaid coordinated care network, as defined in this Section, that provides or administers only dental benefits for Medicaid recipients. See Louisiana Revised Statutes 46:460.51
  • Department: means the Department of Wildlife and Fisheries and its duly authorized representatives. See Louisiana Revised Statutes 34:852.2
  • Department: means the Louisiana Department of Health. See Louisiana Revised Statutes 46:460.51
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • 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
  • Enrollee: means an individual who is enrolled in the Medicaid program. See Louisiana Revised Statutes 46:460.51
  • Executor: A male person named in a will to carry out the decedent
  • Fraud: Intentional deception resulting in injury to another.
  • Hull identification number: means the number assigned to a vessel under Subpart C of 33 C. See Louisiana Revised Statutes 34:852.2
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Legatee: A beneficiary of a decedent
  • Manufacturer: means any person engaged in the business of manufacturing or importing new vessels or outboard motors for the purpose of sale or trade. See Louisiana Revised Statutes 34:852.2
  • operation: means all operations of a vessel or outboard motor when it is at the pier, idle in the water, at anchor, or being propelled through the water. See Louisiana Revised Statutes 34:852.2
  • Outboard motor: means a mechanical combustion engine manufactured to produce a twenty-five or more horsepower engine and designed to attach outboard of the transom of a vessel. See Louisiana Revised Statutes 34:852.2
  • Owner: means a person, other than a secured party, having property rights in, or title to, a vessel or outboard motor. See Louisiana Revised Statutes 34:852.2
  • Person: means any natural person or individual, firm, partnership, corporation, association, limited liability company, or other entity. See Louisiana Revised Statutes 34:852.2
  • person: includes a body of persons, whether incorporated or not. See Louisiana Revised Statutes 1:10
  • provider: means a person, partnership, limited liability partnership, limited liability company, corporation, facility, or institution that provides healthcare or professional services to individuals enrolled in the Medicaid program. See Louisiana Revised Statutes 46:460.51
  • Security interest: means an interest that is reserved or created by an agreement that secures payment or performance of an obligation. See Louisiana Revised Statutes 34:852.2
  • services: means the services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 46:460.51
  • Undocumented vessel: means a vessel for which a certificate of documentation has not been issued by the United States Coast Guard under 46 U. See Louisiana Revised Statutes 34:852.2
  • Vessel: means every description of watercraft and air boats, including homemade boats, other than a seaplane on the water, used or capable of being used as a means of transportation on water, valued in excess of two thousand five hundred dollars, to be principally operated on the waters of this state, required to be numbered, not held as inventory for sale or lease, and transferred for the first time on or after July 1, 2008. See Louisiana Revised Statutes 34:852.2