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27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.htm - 17K - Match Info - Similar pages
11-104-2
Section 11-104-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) DEPENDENTS. The spouse, children, or other dependents of the retired employee,
as defined by and covered under the documents governing the governmental entities' benefit
plans that provide post-employment benefits. (2) EMPLOYEE. Any person who is an employee of
any governmental entity located in the state who may become eligible for post-employment benefits
from the governmental entity. (3) EMPLOYER. Any governmental entity that sponsors, in whole
or in part, post-employment benefits. (4) FISCAL YEAR. The annual period at the end of which
a governmental entity determines its financial condition. (5) GASB. The Governmental Accounting
Standards Board. (6) GOVERNMENTAL ENTITY. Any political subdivision of the state, any department,
agency, board, commission, or authority of any such political subdivision, or any public corporation,
authority, agency, instrumentality, board,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/11-104-2.htm - 2K - Match Info - Similar pages
11-49A-8
Section 11-49A-8 Powers of authority. The authority shall have the following powers, together
with all powers incidental thereto or necessary to the discharge thereof in corporate form:
(1) To have succession by its corporate name for the duration of time (which may be perpetual,
subject to the provisions of Section 11-49A-20) specified in its certificate of incorporation;
(2) To sue and be sued in its own name in civil suits and actions and to defend suits against
it; (3) To adopt and make use of a corporate seal and to alter the same at pleasure; (4) To
adopt and alter bylaws for the regulation and conduct of its affairs and business; (5) To
acquire, receive, and take, by purchase, gift, lease, devise, or otherwise, and to hold property
of every description, real, personal, or mixed, whether located in one or more counties or
municipalities and whether located within or outside the authorizing municipality; (6) To
make, enter into, and execute such contracts, agreements, leases, and...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/11-49A-8.htm - 6K - Match Info - Similar pages
22-21-375
Section 22-21-375 Issuance of license; revocation; procedures for review and mediation of complaints.
(a) The Department of Insurance shall issue a license to each applicant upon payment of the
prescribed fees and upon being satisfied that: (1) The applicant has been organized in a bona
fide manner for the purpose of establishing, maintaining, and operating a dental service plan.
(2) Each contract executed, or proposed to be executed, by the applicant and a dentist obligates,
or will when executed obligate, such dentist to render the service or accept payment for the
service to which each subscriber may be entitled under the terms of the contract issued to
the subscriber. (3) Each contract issued, or proposed to be issued, to subscribers is in a
form approved by the department and that the rates charged, or proposed to be charged, for
each form of such contract and benefits to be provided pursuant thereto are fair and reasonable
and are actuarially sound. (4) No contributions to the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-375.htm - 4K - Match Info - Similar pages
27-21A-3
Section 27-21A-3 Issuance of certificate of authority. (a)(1) Upon receipt of an application
for issuance of a certificate of authority, the commissioner shall forthwith transmit copies
of such application and accompanying documents to the State Health Officer. (2) The State
Health Officer shall determine whether the applicant for a certificate of authority, with
respect to health care services to be furnished: a. Has demonstrated the willingness and potential
ability to assure that such health care services will be provided in a manner to assure both
availability and accessibility of adequate personnel and facilities and in a manner enhancing
availability, accessibility, and continuity of service; b. Has arrangements, established in
accordance with the regulations promulgated by the State Health Officer, for an on-going quality
assurance program concerning health care processes and outcomes; and c. Has a procedure, established
in accordance with regulations of the State Health...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-3.htm - 7K - Match Info - Similar pages
27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54A-2.htm - 10K - Match Info - Similar pages
11-32-7
Section 11-32-7 Powers of authority. (a) The authority shall exercise powers and duties necessary
to the discharge of its powers and duties in corporate form as follows: (1) Have succession
by its corporate name in perpetuity subject to Section 11-32-20. (2) Sue and be sued in its
own name in civil suits and actions and defend suits against it. (3) Adopt and make use of
a corporate seal and alter the same at its pleasure. (4) Adopt and alter bylaws for the regulation
and conduct of its affairs and business. (5) Acquire, receive, take, by purchase, gift, lease,
devise, or otherwise, and hold property of every description, real, personal, or mixed, whether
located in one or more counties or municipalities and whether located within or outside the
authorizing county. (6) Make, enter into, and execute contracts, agreements, leases, and other
instruments and take other actions as may be necessary or convenient to accomplish any purpose
for which the authority was organized, or exercise any...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/11-32-7.htm - 14K - Match Info - Similar pages
40-26B-70
Section 40-26B-70 Definitions. For purposes of this article, the following terms shall have
the following meanings: (1) ACCESS PAYMENT. A payment by the Medicaid program to an eligible
hospital for inpatient or outpatient hospital care, or both, provided to a Medicaid recipient.
(2) ALL PATIENT REFINED DIAGNOSIS-RELATED GROUP (APR-DRG). A statistical system of classifying
any non-Medicare inpatient stay into groups for the purposes of payment. (3) ALTERNATE CARE
PROVIDER. A contractor, other than a regional care organization, that agrees to provide a
comprehensive package of Medicaid benefits to Medicaid beneficiaries in a defined region of
the state pursuant to a risk contract. (4) CERTIFIED PUBLIC EXPENDITURE (CPE). A certification
in writing of the cost of providing medical care to Medicaid beneficiaries by publicly owned
hospitals and hospitals owned by a state agency or a state university plus the amount of uncompensated
care provided by publicly owned hospitals and hospitals...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-70.htm - 5K - Match Info - Similar pages
22-21-318
Section 22-21-318 Powers of authority. (a) In addition to all other powers granted elsewhere
in this article, and subject to the express provisions of its certificate of incorporation,
an authority shall have the following powers, together with all powers incidental thereto
or necessary to the discharge thereof in corporate form: (1) To have succession by its corporate
name for the duration of time, which may be in perpetuity, specified in its certificate of
incorporation or until dissolved as provided in Section 22-21-339; (2) To sue and be sued
in its own name in civil suits and actions, and to defend suits and actions against it, including
suits and actions ex delicto and ex contractu, subject, however, to the provisions of Chapter
93 of Title 11, which chapter is hereby made applicable to the authority; (3) To adopt and
make use of a corporate seal and to alter the same at pleasure; (4) To adopt, alter, amend
and repeal bylaws, regulations and rules, not inconsistent with the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-318.htm - 12K - Match Info - Similar pages
45-47-250.05
Section 45-47-250.05 Powers of authority. (a) The authority shall have the following powers,
together with all powers incidental thereto or necessary to the discharge thereof in corporate
form: (1) To have succession by its corporate name for the duration of time specified in its
certificate of incorporation. (2) To sue and be sued in its own name in civil actions, except
as otherwise provided in this article, and to defend civil actions against it. (3) To adopt
and make use of a corporate seal and to alter the same at pleasure. (4) To adopt and alter
bylaws for the regulation and conduct of its affairs and business. (5) To acquire, receive,
and take, by purchase, gift, lease, devise, or otherwise, and to hold property of every description,
real, personal, or mixed, whether located in one or more counties and whether located within
or outside the service area. (6) To make, enter into, and execute such contracts, agreements,
leases, and other instruments and to take such other actions...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/45-47-250.05.htm - 8K - Match Info - Similar pages
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