Filed Claim definition
Examples of Filed Claim in a sentence
Your Properly Filed Claim must be furnished to the Plan within 180 days after the end of the Benefit Period for which the claim is made.
If the forms are not furnished within 15 days after the Plan receives your notice, you may comply with the Properly Filed Claim requirements by forwarding to the Plan, within the time period set forth below, written proof covering the occurrence, character, and extent of loss for which the claim is made.
Once the Plan receives a Properly Filed Claim from you or your Provider, a Benefit determination will be made within 30 days.
Upon receipt of written notice, the Plan will furnish claim forms to you for submitting a Properly Filed Claim.
Upon receipt of your claim, if the Plan determines that additional information is necessary in order for it to be a Properly Filed Claim, we will provide written notice to you and/or your Provider, prior to the expiration of the initial 30-day period, of the specific information needed.
Failure to provide a Properly Filed Claim to the Plan within the time specified above will not reduce any Benefit if you show that the claim was given as soon as reasonably possible.
If payment is due but not made within the time required by law from receipt of a Properly Filed Claim, it shall bear simple interest at the rate of ten percent (10%) per year.
Upon receipt of the additional information or corrections to make the claim a Properly Filed Claim, the claim shall be processed by The Plan within thirty (30) days, unless otherwise permitted by law.
If upon receipt of a claim, The Plan determines it is not a Properly Filed Claim, written notice shall be given to Group within thirty (30) days of receipt of the claim.
Group is required to submit a Properly Filed Claim for all Covered Services provided to Member.