Kentucky Revised Statutes · § 304.17A-575 — Definitions for KRS 304.17A-575 to 304.17A-577

As used in KRS 304.17A-575 to 304.17A-577, unless the context requires otherwise:

(1) "Applicant" means a physician licensed under KRS Chapter 311, an advanced practice registered nurse licensed under KRS Chapter 314, a psychologist licensed under KRS Chapter 319, or an optometrist licensed under KRS Chapter 320 applying for credentialing;

(2) "Enrollee" means a person who is eligible to receive health care services under a managed care plan;

(3) "Managed care plan" means a health benefit plan that integrates the financing and delivery of appropriate health care services to enrollees by arrangements with participating providers who are selected to participate on the basis of explicit standards to furnish a comprehensive set of health care services and financial incentives for enrollees to use the participating providers and procedures provided for in the plan; and

(4) "Nonparticipating provider" means a physician licensed under KRS Chapter 311, an advanced practice registered nurse licensed under KRS Chapter 314, a psychologist licensed under KRS Chapter 319, or an optometrist licensed under KRS Chapter 320 that has not entered into an agreement with an insurer to provide health care services.