Terms Used In Louisiana Revised Statutes > Title 53 > Chapter 2 - Precautions Against Attack

• Adverse determination: means any of the following relative to a claim by a provider for payment for a healthcare service rendered by the provider to an enrollee of the Medicaid managed care organization:

              (a) A decision by a managed care organization that denies a claim in whole or in part. See Louisiana Revised Statutes 46:460.51

• Agency: means and includes the boards, commissions, departments, agencies, offices, officers, and other instrumentalities, or any or all of these, within the executive branch of state government which are abolished by this Title or which are transferred and placed within departments of the state government created and established or continued by this Title or transferred to and placed within the office of the governor as provided by this Title. See Louisiana Revised Statutes 36:3
• 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.
• 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
• 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
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Office: means each principal operational unit within a department, except the executive office of the secretary. See Louisiana Revised Statutes 36:3
• Secretary: means the officer appointed by the governor as the executive head and chief administrative officer of certain departments created and provided for by this Title. See Louisiana Revised Statutes 36:3
• Trustee: A person or institution holding and administering property in trust.
• Undersecretary: means the officer designated to direct and be responsible for the functions of the office of management and finance of certain departments. See Louisiana Revised Statutes 36:3