Ohio § 3901.38

§ 3901.38.

As used in this section and sections 3901.381 to 3901.3814 of the Revised Code : (A) “ Beneficiary ” means any policyholder, subscriber, member, employee, or other person who is eligible

for benefits under a benefits contract. (B) “ Benefits contract ” means a sickness and accident insurance policy providing hospital, surgical, or

medical expense coverage, or a health insuring corporation contract or other policy

or agreement under which a third-party payer agrees to reimburse for covered health

care or dental services rendered to beneficiaries, up to the limits and exclusions

contained in the benefits contract. (C) “ Hospital ” has the same meaning as in section 3727.01 of the Revised Code . (D) “ Provider ” means a hospital, nursing home, physician, podiatrist, dentist, pharmacist, chiropractor,

or other health care provider entitled to reimbursement by a third-party payer for

services rendered to a beneficiary under a benefits contract. (E) “ Reimburse ” means indemnify, make payment, or otherwise accept responsibility for payment for

health care services rendered to a beneficiary, or arrange for the provision of health

care services to a beneficiary. (F) “ Third-party payer ” means any of the following: (1) An insurance company; (2) A health insuring corporation; (3) A labor organization; (4) An employer; (5) An intermediary organization, as defined in section 1751.01 of the Revised Code , that is not a health delivery network contracting solely with self-insured employers; (6) An administrator subject to sections 3959.01 to 3959.16 of the Revised Code ; (7) A health delivery network, as defined in section 1751.01 of the Revised Code ; (8) Any other person that is obligated pursuant to a benefits contract to reimburse for

covered health care services rendered to beneficiaries under such contract.