P.R. Laws tit. 26, § 9463

2019-02-20 00:00:00+00
§ 9463. Definitions

For purposes of this chapter:

(a) Intermediary.— Means a person authorized to negotiate and execute contracts with health insurance organizations or issuers on behalf of healthcare providers or a healthcare provider network.

(b) Primary care provider.— Means a participating provider in charge of supervising, coordinating or providing initial care or continuing care to a covered person or enrollee. In addition, the primary care provider may be required by the health insurance organization or issuer to initiate a referral for specialty care and maintain supervision of healthcare services rendered to the covered person or enrollee.

(c) Network.— Means the group of participating providers providing services to a managed care plan.

History —Aug. 29, 2011, No. 194, added as § 26.030 on Aug. 23, 2012, No. 203, § 6, eff. 90 days after Aug. 23, 2012.