Claims Paid means, of the applicable Recognized Charges, the amount payable and paid to Facility by the applicable Payor.
Claims Paid means the amounts paid for the covered employees of an employer by an insurer, health care center, hospital service corporation, medical service corporation or other entity as specified in subsection (b) of this section for medical services and supplies and for prescriptions filled, but does not include expenses for stop-loss coverage, reinsurance, enrollee educational programs or other cost containment programs or features, administrative costs or profit.
Examples of Claims Paid in a sentence
Facility also agrees, however, that in lieu of or in addition to any such fee that may be charged to Payors, Crescent may charge Facility an administrative fee (limited to no greater than 5% of Claims Paid), as may be determined from time to time by Crescent, as compensation for the administrative services provided to Facility pursuant to Article IX of this Agreement.
Crescent's agreements with Payor or TPA shall generally state that, except in circumstances that are extraordinary or beyond the control of Facility, all xxxxxxxx by Facility will be considered final unless Facility requests adjustments in writing within ninety (90) days after the Facility receives the applicable Claims Paid with respect to such billing.
More Definitions of Claims Paid
Claims Paid means all payments made by a health carrier
Claims Paid means a payment made by the INSURER on behalf of the INSURED pursuant to a judgment, or by way of repair or settlement of a CLAIM.
Claims Paid means the basis on which benefits may be made available to Members as stated in Rule 6.4;
Claims Paid means a dollar amount determined in accordance with statutory annual statement reporting . . . .”506 Residual reserve, in turn, is calculated as 3.3 percent of the combination of paragraphs (i), (iii), and (iv) of the total losses incurred definition.507
Claims Paid means a dollar amount determined in accordance with statutory annual statement reporting and consistent with N.J.A.C. 11:20-8.5(c), adjusted as required by this subchapter.
Claims Paid means claims that are calculated as prescribed in the carrier’s Statement of Revenue and Expenses, or its equivalent, which is a required component of the annual statement filing.