Completed claim definition

Completed claim means a proof of loss or a claim for payment for health care services which has been submitted to the appropriate claims processing office of the third-party payer accompanied by sufficient documentation for the third-party payer to determine proof of loss and reasonably required by the third-party payer to accept or reject the claim.

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Completed claim means a claim for payment for Covered Services submitted by an MHSA Provider, a non-MHSA Provider when authorized by PBHC, or a Member (in the case of Out-of-Network Services) which is complete and accurate in all respects and raises no issue with respect to responsibility for payment of the claim.

Completed claim means a request for payment for Covered Services submitted by Ancillary Service that is accurate, complete, and in the form agreed to by the parties.

Examples of Completed claim in a sentence

Completed claim forms should be sent to the address in the How Your Coverage Works section of this Contract.
Completed claim forms should be sent to the address on Your ID card.
Completed claim forms and processing documents must be furnished to Us within the stipulated timelines for all reimbursement claims.
Completed claim forms and the necessary processing documents must be furnished to Us within the stipulated timelines for all claims.
Completed claim forms will be submitted to the Insurer who will assess the claim.
Completed claim forms will be checked by the Company to determine whether or not an employee is a participant in the Plan and the Company may then forward the claim forms to the insurer as its agent for further processing.
Completed claim forms will be checked by the Company to determine whether or not an employee is a participant in the plan, and the Company will forward the claim forms to the insurer for adjudication and processing.
Completed claim forms, together with any relevant medical certificates, must be sent to the Council’s Insurance Section on a regular monthly basis.
Completed claim forms will be checked by the company to determine whether or not an employee is a participant in the Plan and the company may then forward the claim forms to the insurer as its agent for further processing.
Completed claim forms should be sent to the address in the How Your Coverage works section of this Policy.

More Definitions of Completed claim

Completed claim means a payment request submitted to a third-party payer which is accompanied by reasonable and sufficient information that will enable the third-party payer to accept or reject the claim.