Final Denial definition

Final Denial has the meaning set forth in Section 4.3(a)(ii).
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Final Denial means a Denial of benefits under the Medical Benefit Program that has been upheld by the Claims Administrator at the completion of the internal appeals process conducted pursuant to Section 11.06, or a Denial of benefits under the Medical Benefit Program with respect to which the internal appeals process has been deemed exhausted as described under Section 11.12 (a "deemed Final Denial").
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Final Denial means a Denial of Health Benefits that has been upheld by the Claims Supervisor at the completion of the internal claims procedure pursuant to Section 13.02, or a Denial of Health Benefits with respect to which the internal claims procedure has been deemed exhausted as described under Section 13.02 (a "deemed Final Denial").
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Examples of Final Denial in a sentence

  • F F Order of Final Denial issued on 12-28- 09 per Memo instruction from CO dated November 25, 2009.

  • Guidelines to determine if an uninsured discount qualifies based on Partially Exhausted Benefits (All three guidelines must be met):  The remit indicates a Final Denial, or verbiage used on the remit such as “Exhausted Benefits” or “Maximum Coverage Exceeded” and  The patient was considered for Charity for the remaining balance and not approved and  Days being considered for the uninsured discount were not covered by insurer.

  • If the Remaining Coverage Amount has been reduced to zero at the time such action on the Claim becomes final, ▇▇▇▇▇▇▇ Mac shall have no liability to Radian in respect of such Final Rescission, Final Cancellation, Final Curtailment, or Final Denial.


More Definitions of Final Denial

Final Denial means a denial of benefits under the medical plan or dental plan that has been upheld by the claims administrator at the completion of the internal appeals process or a denial of benefits under the medical plan or dental plan with respect to which the internal appeals process has been deemed exhausted (a "deemed final denial").
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Final Denial or “Final Curtailment,” as the case may be);
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Final Denial means the denial of a proposed project by the Loan Committee.
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Related to Final Denial

  • Final Decree means the decree contemplated under Bankruptcy Rule 3022.

  • Denial means the process of refusing to grant a license after OCCL receives an application. This constitutes refusal of permission to operate.

  • Final Determination means the final resolution of liability for any Tax for any taxable period, by or as a result of (a) a final decision, judgment, decree or other order by any court of competent jurisdiction that can no longer be appealed, (b) a final settlement with the IRS, a closing agreement or accepted offer in compromise under Sections 7121 or 7122 of the Code, or a comparable agreement under the Laws of other jurisdictions, which resolves the entire Tax liability for any taxable period, (c) any allowance of a refund or credit in respect of an overpayment of Tax, but only after the expiration of all periods during which such refund or credit may be recovered by the jurisdiction imposing the Tax, or (d) any other final resolution, including by reason of the expiration of the applicable statute of limitations or the execution of a pre-filing agreement with the IRS or other Taxing Authority.

  • Final Determination Date means the following: