Compilation of Rules and Regulations of the State of Georgia
Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER
Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE
Subject 120-2-59 - STANDARD CLAIM FORM FOR ACCIDENT AND SICKNESS INSURANCE
Rule 120-2-59-.04 - Definitions
Current through Rules and Regulations filed through September 23, 2024
For the purposes of O.C.G.A. 33-24-10.1 and this Regulation Chapter:
(a) "HCFA" means the Health Care Financing Administration of the United States Department of Health and Human Services.
(b) "HCFA Form 1450" means the health insurance claim form maintained by HCFA for use by institutional care practitioners.
(c) "HCFA Form 1500" means the health insurance claim form maintained by HCFA for use by health care practitioners.
(d) "Health Care Practitioner" means a health care provider duly licensed by the Secretary of State of the State of Georgia pursuant to the Official Code of Georgia Annotated and the Rules and Regulations of the State of Georgia.
(e) "Institutional Care Practitioner" means a hospice, hospital, skilled nursing facility, extended care facility, intermediate care facility, convalescent nursing home, and personal care facility licensed pursuant to the Official Code of Georgia Annotated and the Rules and Regulations of the State of Georgia.
(f) "Insured" means an individual covered under a policy of insurance or the provider to which that individual has assigned benefits.
(g) "Issuer" means an insurance company, fraternal benefit society, health care service plan, health maintenance organization, third party administrator, and any other entity reimbursing the costs of health care expenses.
(h) "J512 Form" means the uniform dental claim form approved by the American Dental Association for use by dentists.
O.C.G.A. Secs. 33-2-9, 33-24-10.1.
