Terms Used In Montana Code 33-32-415

• Authorized representative: means :

  (a)a person to whom a covered person has given express written consent to represent the covered person;

  (b)a person authorized by law to provided substituted consent for a covered person; or

  (c)a family member of the covered person, or the covered person's treating health care provider, only if the covered person is unable to provide consent. See Montana Code 33-32-102

• Covered person: means a policyholder, a certificate holder, a member, a subscriber, an enrollee, or another individual participating in a health plan. See Montana Code 33-32-102
• External review: describes the set of procedures provided for in Title 33, chapter 32, part 4. See Montana Code 33-32-102
• Final adverse determination: means an adverse determination involving a covered benefit that has been upheld by a health insurance issuer or its designated utilization review organization at the completion of the health insurance issuer's internal grievance process as provided in Title 33, chapter 32, part 3. See Montana Code 33-32-102
• Health insurance issuer: has the meaning provided in 33-22-140. See Montana Code 33-32-102
• Person: means an individual, a corporation, a partnership, an association, a joint venture, a joint stock company, a trust, an unincorporated organization, or any similar entity or combination of entities in this subsection. See Montana Code 33-32-102
• State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Montana Code 1-1-201