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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