Adjudicated Claims definition

Adjudicated Claims or “Adjudicated Encounters” means claims or encounters that have been received and processed by the Contractor, and which resulted in a payment or denial of payment.
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Adjudicated Claims means those Claims which, after Adjudication, have been identified as meeting applicable Contract Pharmacy Agreement standards for the dispensing of Covered Drugs.
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Examples of Adjudicated Claims in a sentence

  • Any term or provision of this Lease to the contrary notwithstanding, the covenants and obligations of Tenant to pay Rent hereunder shall be independent from any obligations, warranties or representations, express or implied, if any, of Landlord herein contained or in the Related Agreements, except to the extent of any Adjudicated Claims.

  • Examples of Claims Reports to be submitted by the Contractor, in accordance with the terms of the MCE Reporting Manuals, include but are not limited to:  Adjudicated Claims Summary, including Claims Aging Summary and Claims Lag Report;  Top 10 Claims Denial Reasons; and  Claims Processing Summary, including Outstanding Claims Inventory Summary and Interest Paid on Claims.

  • An employee suffering prolonged illness shall, on application, be granted definite leave of absence as follows when all sick leave credits have been expended: Accepted Adjudicated Claims Subject to Article 23: Employees suffering from prolonged illness and have had their claim adjudicated and accepted by a third party shall, upon request, be placed on a leave of absence.

  • Adjudicated Claims Inventory Summary Monthly, no later than fifteen (15) days after the close of the reporting month No Contractor shall report the number of claims Contractor adjudicated by claim type for both paper and electronic claims, in-network and out-of-network break out, and the number of days the claims took to process.

  • Claim Type Unpaid Adjudicated Claims (In Dollars) (2) 1-30 Days 31-45 Days 46-60 Days 61-90 Days 91-120 Days >120 Days Total Unpaid Adjudicated Claims (In Dollars) At The End Of The Qtr.

  • Adjudicated Claims Percent of adjudicated claims submitted to Contractors that were paid within the timely filing requirements.

  • CMS/DMAS defined X Plans of Care Percent of Enrollees with Plans of Care developed within specified timeframes CMS/DMAS defined X Adjudicated Claims Percent of adjudicated claims submitted to Contractors that were paid within the timely filing requirements.

  • The Parties acknowledge and agree that any Adjudicated Claims (as defined in the Vendor Loan) may, if not satisfied by the Vendor, be set-off against the Vendor Loan or deducted from the Escrow Retention Amount (as defined in the Vendor Loan), as relevant, in each case in accordance with the terms of the Vendor Loan.

Related to Adjudicated Claims

  • Exculpated Claim means any Claim related to any act or omission in connection with, relating to, or arising out of the Debtors’ post-petition restructuring efforts, the Chapter 11 Cases, formulation, preparation, dissemination, negotiation, filing, solicitation of acceptances, confirmation, approval, implementation, or administration of the Disclosure Statement, the Plan, the settlements and agreements contained in the Plan, the property to be distributed under the Plan or any contract, instrument, release, or other agreement or document created or entered into in connection with the Disclosure Statement or the Plan, the filing of the Debtors’ Chapter 11 Cases, the pursuit of entry of a Confirmation Order, the distribution of property under the Plan, or any other related agreement; provided, however, that Exculpated Claims shall not include any act or omission that is determined in a Final Order to have constituted willful misconduct or gross negligence. For the avoidance of doubt, no Claim, Cause of Action, obligation, or liability expressly set forth in or preserved by the Plan constitutes an Exculpated Claim.

  • Unimpaired Claim means a Claim that is not impaired within the meaning of section 1124 of the Bankruptcy Code.

  • Related Claims means all Claims for Wrongful Acts based upon, arising out of, resulting from, or in any way involving the same or related facts, circumstances, situations, transactions or events or the same or related series of facts, circumstances situations, transactions or events, whether related logically, causally or in any other way.

  • Adjudicative proceeding means the procedure to be followed in contested cases, as set forth in RSA 541-A:31 through RSA 541-A:36.

  • Contested Claim means any Tax, Indebtedness or other claim or liability (i) the validity or amount of which is being diligently contested in good faith, (ii) for which adequate reserve, or other appropriate provision, if any, as required in conformity with GAAP shall have been made, and (iii) with respect to which any right to execute upon or sell any assets of the Company or of any of its Subsidiaries has not matured or has been and continues to be effectively enjoined, superseded or stayed.