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Current as of January 01, 2024 | Updated by FindLaw Staff
In this chapter:
(1) “Ancillary service” means a facility item or service that a facility customarily provides as part of a shoppable service.
(2) “Chargemaster” means the list of all facility items or services maintained by a facility for which the facility has established a charge.
(3) “Commission” means the Health and Human Services Commission.
(4) “De-identified maximum negotiated charge” means the highest charge that a facility has negotiated with all third party payors for a facility item or service.
(5) “De-identified minimum negotiated charge” means the lowest charge that a facility has negotiated with all third party payors for a facility item or service.
(6) “Discounted cash price” means the charge that applies to an individual who pays cash, or a cash equivalent, for a facility item or service.
(7) “Facility” means a hospital licensed under Chapter 241.
(8) “Facility items or services” means all items and services, including individual items and services and service packages, that may be provided by a facility to a patient in connection with an inpatient admission or an outpatient department visit, as applicable, for which the facility has established a standard charge, including:
(A) supplies and procedures;
(B) room and board;
(C) use of the facility and other areas, the charges for which are generally referred to as facility fees;
(D) services of physicians and non-physician practitioners, employed by the facility, the charges for which are generally referred to as professional charges; and
(E) any other item or service for which a facility has established a standard charge.
(9) “Gross charge” means the charge for a facility item or service that is reflected on a facility's chargemaster, absent any discounts.
(10) “Machine-readable format” means a digital representation of information in a file that can be imported or read into a computer system for further processing. The term includes .XML, .JSON, and .CSV formats.
(11) “Payor-specific negotiated charge” means the charge that a facility has negotiated with a third party payor for a facility item or service.
(12) “Service package” means an aggregation of individual facility items or services into a single service with a single charge.
(13) “Shoppable service” means a service that may be scheduled by a health care consumer in advance.
(14) “Standard charge” means the regular rate established by the facility for a facility item or service provided to a specific group of paying patients. The term includes all of the following, as defined under this section:
(A) the gross charge;
(B) the payor-specific negotiated charge;
(C) the de-identified minimum negotiated charge;
(D) the de-identified maximum negotiated charge; and
(E) the discounted cash price.
(15) “Third party payor” means an entity that is, by statute, contract, or agreement, legally responsible for payment of a claim for a facility item or service.
Cite this article: FindLaw.com - Texas Health and Safety Code - HEALTH & SAFETY § 327.001. Definitions - last updated January 01, 2024 | https://codes.findlaw.com/tx/health-and-safety-code/health-safety-sect-327-001/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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