Claim Processing Accuracy definition

Claim Processing Accuracy means the accuracy rate achieved by HMO in processing claims in accordance with the provisions of a group’s medical benefit Coverage administered by HMO.
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Examples of Claim Processing Accuracy in a sentence

  • The penalty for Contractor's failure to meet the Claim Processing Accuracy shall be the amount shown in Attachment A.

  • Claims Payment -Financial Accuracy -Claim Processing Accuracy 99% of audited claim dollars paid accurately.

  • Claim Processing Accuracy is determined from an audit of randomly selected claims.

  • The Claim Processing Accuracy percentage is calculated dividing the number of accurately processed claims by the number of claims selected in the sample.

  • Claims Payment - Financial Accuracy - Claim Processing Accuracy 99% of audited claim dollars paid accurately.

  • Call/Inquiry -Average Speed of Answer (ASA) Claims Payment - Financial Accuracy - Claim Processing Accuracy Measured for the Term of the Agreement, results will not exceed: ●100% of calls within 30 seconds to answer a phone call ●80% of calls within 30 seconds to answer a phone call 99% of audited claim dollars paid accurately.

  • Claim Processing Accuracy refers to Claims without processing errors such as: 1.

  • County of Orange Human Resource Services/Employee Benefits Claims Payment -Financial Accuracy -Claim Processing Accuracy 99% of audited claim dollars paid accurately.

  • Account Level-HMO .0470.6% of actual annual premium Total Financial Commitment .423 2.0% of actual annual premium Client Name: County of Orange Account and/or SOC Number: Lead Claim Office: Agreement Term: Projected # of Enrolled Employee Lives: Sales Representative: Sales Office/Routing #: Underwriter Approval By: Claims Payment - Financial Accuracy - Claim Processing Accuracy 99% of audited claim dollars paid accurately.

  • PROPOSED PERFORMANCE COMMITMENTS AND PENALTIES – EARLY RETIREE PLANSMEDICAL/HMO BENEFITS PLAN Claims Payment - Financial Accuracy - Claim Processing Accuracy 99% of audited claim dollars paid accurately.

Related to Claim Processing Accuracy

  • Claims processing services means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include:

  • processing aid means any substance not consumed as a food ingredient by itself, intentionally used in the processing of raw materials, foods or their ingredients, to fulfil a certain technological purpose during treatment or processing and which may result in the unintentional but technically unavoidable presence of residues of the substance or its derivatives in the final product, provided that these residues do not present any health risk and do not have any technological effect on the finished product;

  • Claims Allocation and Handling Agreement means the agreement of that name approved by ▇▇▇;

  • CEC Certification and Verification means that the CEC has certified (or, with respect to periods before the Project has commenced commercial operation (as such term is defined by and according to the CEC), that the CEC has pre-certified) that the Project is an ERR for purposes of the California Renewables Portfolio Standard and that all Energy produced by the Project qualifies as generation from an ERR for purposes of the Project.

  • Data Processing Agreement means the data processing agreement located at ▇▇▇.▇▇▇▇▇▇.▇▇▇/[countrycode]/legal/dpa, where “[countrycode]” means the two-letter abbreviation for the country where your Stripe Account is located.