Individual who begins a civil legal action.
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Individual who brings a law suit against a defendant.

Referring to a managed care plan.

Department responsible for supervision of a managed care plan with job duties such as accounting, billing, legal services, marketing, personnel, purchasing, servicing of accounts, and underwriting.

Under the Health Insurance Portability and Accountability Act (HIPAA), management performed by the plan sponsor of a group health plan on behalf of the group health plan and excludes functions performed by the plan sponsor in connection with any other benefit or benefit plan of the plan sponsor.

Amount of time, in years, that a managed care plan has operated.

Region of a managed care plan’s membership. Also may be referred to as plan code.

1. Record that may be written in technical terms containing all provisions of the running of a managed care plan such as filing of claims, payment of claims, deductibles, copayment fees, prescription drug plan, and coordination of benefits. See also benefit limitations and explanation of coverage (EOC). Also called health plan document. 2. Written agreement stating all of the benefits of an employer’s pension plan for the employees and requirements they must have to qualify for those benefits.

Payer employee who manages contracts and contract negotiations for one or more managed care plans.