Institutional claims definition

Institutional claims means claims for services that are submitted by institutional providers on a CMS Form 1450 or ANSI Accredited Standards Committee (ASC) X12 institutional claim format. These claims may be paid from either the Medicare Part A or Part B trust fund.
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Examples of Institutional claims in a sentence

  • Claims must be submitted electronically either through HIPAA Compliant Transaction Sets 820 – Premium Payment, 834 – Member Enrollment and Eligibility Maintenance, 835 – Remittance Advice, 837P – Professional claims, 837I – Institutional claims, or the LME/PIHP’s secure web based billing system.

  • Claims must be submitted electronically either through HIPAA Compliant Transaction Sets 820 – Premium Payment, 834 – Member Enrollment and Eligibility Maintenance, 835 – Remittance Advice, 837P – Professional claims, 837I – Institutional claims, or Alliance’s secure web based billing system.

  • Claims must be submitted to the LME/PIHP electronically either through HIPAA Compliant 5010 EDI Transaction Sets: 837P – Professional claims, 837I – Institutional claims, or through direct data entry in the LME/PIHP’s secure web based claims system.

  • Claims must be submitted electronically either through HIPAA Compliant Transaction Sets; 837P – Professional claims, 837I – Institutional claims, or the BH I/DD Tailored Plan’s secure web based billing system.

  • The Medicare encounter claims submitted to the State shall include: • Professional and Institutional claims submitted to CMS; • Part D Pharmacy claims submitted to CMS; and • Supplemental benefit claims.

  • Claims must be submitted electronically either through HIPAA Compliant Transaction Sets 820 – Premium Payment, 834 – Member Enrollment and Eligibility Maintenance, 835 – Remittance Advice, 837P – Professional claims, 837I – Institutional claims, or Alliance’s secure web-based billing system.

  • ClarEdi has issued to company certification through level 6 for Medical, Dental, and Institutional claims.

  • All claims must be submitted electronically either through HIPAA Compliant Transaction Sets 820 – Premium Payment, 834 – Member Enrollment and Eligibility Maintenance, 835 – Remittance Advice, 837P – Professional claims, 837I – Institutional claims, or the EASTPOINTE secure web based billing system.

  • Claims must be submitted electronically either through HIPAA Compliant Transaction Sets 820 – Premium Payment, 834 – Member Enrollment and Eligibility Maintenance, 835 – Remittance Advice, 837P – Professional claims, 837I – Institutional claims, or the PLAN’s secure web based billing system.

  • Institutional claims that meet standardized X12 EDI Transaction Standard: 837I - Institutional Claims.

Related to Institutional claims

  • Environmental Claims means any and all administrative, regulatory or judicial actions, suits, demands, demand letters, claims, liens, notices of noncompliance or violation, investigations or proceedings relating in any way to any Environmental Law.

  • Professional Claim means an Administrative Claim of a Professional for compensation for services rendered or reimbursement of costs, expenses, or other charges and disbursements incurred relating to services rendered or expenses incurred after the Petition Date and prior to and including the Confirmation Date.

  • Insolvency Proceedings means bankruptcy, liquidation or other collective judicial or administrative proceedings, including interim proceedings, in which the assets and affairs of the debtor are subject to control or supervision by a court for the purposes of reorganisation or liquidation;

  • Adjudicative proceeding means the procedure to be followed in contested cases, as set forth in RSA 541-A:31 through RSA 541-A:36.

  • Pending Claims shall have the meaning set forth in Section 7.1(e).