Delaware Administrative Code
Title 18 - Insurance
1300 - Health Insurance General Provisions
1312 - Standards of payment for Assistants at Surgery [Formerly Regulation 83]
Section 1312-2.0 - Definitions
Current through Register Vol. 28, No. 3, September 1, 2024
2.1 For the purpose of this regulation, the following definitions shall apply:
"Assistant at Surgery" means a physician, nurse practitioner, clinical nurse specialist, or physician assistant who is licensed and actively assists the physician in charge of a case in performing a surgical procedure.
"Fee schedule" means the monetary allowance payable to a healthcare provider for services rendered as provided for by agreement between the health care provider and the health insurer.
"Health Care Provider" means any entity or individual licensed, certified or otherwise permitted by law to provide health care in the ordinary course of business, practice or profession.
"Health insurer" means health insurance companies, health maintenance organizations, health service corporations and any other entity providing a plan of health insurance or benefits subject to state insurance regulations.
"Policyholder or Certificate Holder" means a person covered under such policy or a representative designated by such person and entitled to services provided in the policy.
