Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 53 - HEALTH BENEFIT PLANS
Section 836-053-1406 - Definitions
Universal Citation: OR Admin Rules 836-053-1406
Current through Register Vol. 63, No. 9, September 1, 2024
(1) As used in ORS 743.874 and 743.876, "provider" means a person licensed, certified or otherwise authorized or permitted by laws of this state to administer medical or mental health services in the practice of a profession.
(2) As used in ORS 743.876, for the purpose of an insurer's procedure for providing an estimate of an enrollee's costs for a covered out-of-network procedure or service:
(a) The "allowable charge" for a covered
procedure or service is the estimated amount established under the insurance
policy, whether expressed as an "allowable charge," "allowable expense,"
"eligible fee" or other term denoting the amount on which the benefit is
calculated.
(b) The "billed charge"
is the estimated amount charged by a provider for performance of a procedure or
service.
Stat. Auth.: ORS 731.244 & 743.893
Stats. Implemented: ORS 743.874 & 743.876
Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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