Code of Maryland Regulations
Title 31 - MARYLAND INSURANCE ADMINISTRATION
Subtitle 10 - HEALTH INSURANCE-GENERAL
Chapter 31.10.12 - Uniform Consultation Referral
Section 31.10.12.02 - Definitions

Universal Citation: MD Code Reg 31.10.12.02

Current through Register Vol. 51, No. 26, December 27, 2024

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Carrier" means:
(a) An insurer;

(b) A nonprofit health service plan;

(c) A health maintenance organization; or

(d) A dental plan organization.

(2) "Consultant/facility provider" means:
(a) A person licensed or certified under Health Occupations Article, Annotated Code of Maryland, who receives a referral from a primary or requesting provider; or

(b) Hospitals and related institutions that receive a referral from a primary or requesting provider.

(3) "Hospital" has the meaning stated in Health-General Article, §19-301, Annotated Code of Maryland.

(4) "Primary or requesting provider" means a person licensed or certified under the Health Occupations Article, Annotated Code of Maryland, who refers patients for consultation to a consultant/facility provider.

(5) "Related institution" has the meaning stated in Health-General Article, §19-301, Annotated Code of Maryland.

(6) "Uniform consultation referral form" means:
(a) For dentists referring patients for dental care procedures or services, the Maryland Uniform Dental Consultation Referral Form or its electronic equivalent shown in Regulation .08 of this chapter; or

(b) For all other health care professionals referring patients for health, medical, or dental care procedures or services, the Maryland Uniform Consultation Referral Form or its electronic equivalent shown in Regulation.06 of this chapter.

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