Ins. Code Section 1452.101
(1)“Applicant physician” means a physician applying for expedited credentialing under this subchapter.
(2)“Enrollee” means an individual who is eligible to receive health care services under a managed care plan.
(3)“Health care provider” means:
(A)an individual who is licensed, certified, or otherwise authorized to provide health care services in this state; or
(B)a hospital, emergency clinic, outpatient clinic, or other facility providing health care services.
(4)“Managed care plan” means a health benefit plan under which health care services are provided to enrollees through contracts with health care providers and that requires enrollees to use participating providers or that provides a different level of coverage for enrollees who use participating providers. The term includes a health benefit plan issued by:
(A)a health maintenance organization;
(B)a preferred provider benefit plan issuer; or
(C)any other entity that issues a health benefit plan, including an insurance company.
(5)“Medical group” means:
(A)a single legal entity owned by two or more physicians;
(B)a professional association composed of licensed physicians;
(C)any other business entity composed of licensed physicians as permitted under Subchapter B (Authority to Form Certain Jointly Owned Entities), Chapter 162 (Regulation of Practice of Medicine), Occupations Code; or
(D)two or more physicians on the medical staff of, or teaching at, a medical school or medical and dental unit, as defined or described by Section 61.003 (Definitions), 61.501 (Definitions), or 74.601 (Use and Control), Education Code.
(6)“Participating provider” means a health care provider who has contracted with a health benefit plan issuer to provide services to enrollees.
Section 1452.101 — Definitions,
https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1452.htm#1452.101 (accessed Dec. 2, 2023).