{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6050.2","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6050.2","heading":"Definitions","body":"As used in the Out-of-Network Ambulance Service Provider Act:\n\n1. “Ambulance service provider” means an ambulance service as\n\ndefined by Section 1-2503 of Title 63 of the Oklahoma Statutes\n\nexcept that, for the purposes of this act, the term shall be limited\n\nto an ambulance service provider that provides ground transportation\n\nservices;\n\n2. “Covered ambulance services” means those ground ambulance\n\nservices which an enrollee is entitled to receive under the terms of\n\na health care benefit plan;\n\n3. “Enrollee” means a person who is entitled to receive covered\n\nambulance services under the terms of a health care benefit plan;\n\n4. “Health care benefit plan” means a plan, policy, contract,\n\ncertificate, agreement, or other evidence of coverage for health\n\ncare services offered, issued, renewed, or extended in this state by\n\na health care insurer, or government-sponsored self-insured plans.\n\nHealth care benefit plan does not include any health plan offered by\n\na contracted entity as defined in Section 4002.2 of Title 56 of the\n\nOklahoma Statutes that provides coverage to members of the state\n\nMedicaid program;\n\n5. “Health care insurer” means an entity that is subject to\n\nstate insurance regulation and provides coverage for health benefits\n\nin this state and includes the following:\n\na. an insurance company,\n\nb. a health maintenance organization,\n\nc. a hospital and medical service corporation,\n\nd. a risk-based provider organization, or\n\ne. a sponsor or self-funded plan.\n\nHealth care insurer does not include a contracted entity as defined\n\nin Section 4002.2 of Title 56 of the Oklahoma Statutes that provides\n\ncoverage to members of the state Medicaid program;\n\n6. “Out-of-network” means a provider that does not contract\n\nwith the health care insurer of the enrollee receiving the covered\n\nambulance services; and\n\n7. “Clean claim” means a claim that has no defect of\n\nimpropriety, including any lack of required substantiating\n\ndocumentation or particular circumstances requiring special\n\ntreatment that prevents timely payment from being made on the claim.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"d2b991358ef79667ac6d1188c08ef58550741982274d083d1a59fba7b61dbc5a","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6050.1","next":"us-ok/okla.-stat.-tit.-36-36-6050.3"},"notice":"GroundRules: Original legal text. Not legal advice."}