Claims Payment definition

Claims Payment is defined as making an independent determination to pay, deny or pend claims for payment. This is different from the ministerial task of writing a check for payment based upon the decision to act on a claim made by a different entity.

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Claims Payment means the payment of an ORIGINAL REINSURANCE CLAIM made by the AGENT on behalf of the PRINCIPAL to a REINSURED pursuant to the PRINCIPAL's obligations under an ORIGINAL REINSURANCE CONTRACT.

Claims Payment means the total amount of monies and shares of Parent Common Stock paid to Parent pursuant to a Claim Notice and Section 9.2.

Examples of Claims Payment in a sentence

• The Claims Payment Director is responsible for oversight of all physical and behavioral health claims payment- and encounter-related activities.

• The organizational chart must include the names, titles, and contact information for the following key staff positions or functions: Contract Liaison/Medicaid Administrator, Chief Financial Officer, Medical Director, Medical Management (Utilization Review/Care Management) Director, Quality Director, Member Services Director, Claims Payment Director, Provider Relations Director, and Information Technology Director.

• The Managing General Agent shall, and shall cause its officers and employees to, only use such Claims Payment Account for the payment of losses, claims and loss adjustment expenses under the Subject Business that are reinsured under the Reinsurance Agreement.

• BJC shall then have one business day to transfer the necessary amount via ACH transfer from an alternative BJC account into the Claims Payment Account.

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

• The Managing General Agent shall establish reasonable controls, policies and procedures designed to ensure that the Claims Payment Account is only used for such purposes.

• Every week the TPA will notify the Plan Sponsor of the Claims batch amount required to be prospectively deposited to the Claims Payment Account to pay the Claims liability after these Claims are processed for payment.

• The Claims Payment Report shall not include requests for the payment of Claims that are determined not to be Medically Necessary.

• The Claims Payment Report shall be certified by the Authorized Signatory in accordance with Sections 15.4 and 22 of this Contract.

• The Claims Payment Director is responsible for oversight of all physical and behavioral health claims payment and encounters related activities.

More Definitions of Claims Payment

Claims Payment means a payment from the Claim Fund, or an account or subaccount thereof, to a Claimant for any GCCF Administered Claim.

Claims Payment. The amount that ASES pays the Contractor for Claims submitted by Providers for Covered Services provided to Enrollees under this Contract.