Net Claim Payment definition

Net Claim Payment. ’ means the net benefit payment, calculated by the Plan, upon submission of a Claim, in accordance with the benefits specified in the Certificate Booklet plus any related Surcharges. All Net Claim Payments shall be calculated on the basis of the Provider’s Eligible Charge for Covered Services rendered to the Covered Person irrespective of any separate finan- cial arrangement between the Plan and the particular Provider. (See Section IV. A. of this Group Administration Document regarding the Plan’s Separate Financial Arrangements with Providers.)
Sample 1
Net Claim Payment means the net benefit payment calculated by Claim Administrator, upon submission of a Claim, in accordance with the benefits specified in the Plan for which Claim Administrator has agreed to provide administrative services under this Agreement, plus any related Surcharges. All Net Claim Payments shall be calculated on the basis of the Provider’s Eligible Charge for Covered Services rendered to the Covered Person, less the ADP if applicable, irrespective of any separate financial arrangement between Claim Administrator and the particular Provider. (See provisions regarding “Claim Administrator’s Separate Financial Arrangements With Providers And Other Entities” in Exhibit 3.) The term “Net Claim Payment” also includes Employer’s share of Alternative Provider Compensation Arrangement Payments, whether billed to Employer as part of a Claim or billed separately, as described in the definition of “Alternative Provider Compensation Arrangement Payments” in Exhibit 5.
Sample 1
Net Claim Payment means the net benefit payment calculated by the Fund, upon submission of a Claim, in accordance with the benefits specified in the Plan, plus any related Surcharges. All Net Claim Payments shall be calculated by the Fund on the basis of the Provider’s Eligible Charge for Covered Services rendered to the Covered Person as determined by the Fund, less the ADP as determined by the Blue Cross if applicable, irrespective of any separate financial arrangement between Blue Cross and the particular Provider. (See provisions of the Network Administration Agreement regarding “BLUE CROSS’S SEPARATE FINANCIAL ARRANGEMENTS WITH PROVIDERS.”)
Sample 1

More Definitions of Net Claim Payment

Net Claim Payment means the net benefit payment calculated by the Claim Administrator, upon submission of a Claim, in accordance with the benefits specified in the Plan, plus any related Surcharges. All Net Claim Payments shall be calculated on the basis of the Provider’s Eligible Charge for Covered Services rendered to the Covered Person, less the ADP if applicable, irrespective of any separate financial arrangement between the Claim Administrator and the partic- ular Provider. (See provisions regarding “CLAIM ADMINISTRATOR’S SEPARATE FINANCIAL ARRANGEMENTS WITH PROVIDERS” in Exhibit 2 of this Agreement.)
Sample 1

Related to Net Claim Payment

  • Payment Claim means the claim for payment made by the Contractor in accordance with this Contract.

  • Indemnity Claim has the meaning set forth in Section 8.3.

  • Earnout Payment has the meaning set forth in Section 2.3(b).

  • Indemnity Payment shall have the meaning set forth in Section 4.4(a).

  • Closing Cash Payment has the meaning set forth in Section 2.06(a).

  • Settlement Payment means the transfer, or contractual undertaking (including by automated clearing house transaction) to effect a transfer, of cash or other property to effect a Settlement.

  • Claimed Amount means the amount of any Damages incurred or reasonably expected to be incurred by the Indemnified Party.

  • Claim Expenses means reasonable documented attorneys’ fees and all other reasonable documented out-of-pocket costs, expenses and obligations (including experts’ fees, travel expenses, court costs, retainers, transcript fees, duplicating, printing and binding costs, as well as telecommunications, postage and courier charges) paid or incurred in connection with investigating, defending, being a witness in or participating in (including on appeal), or preparing to investigate, defend, be a witness in or participate in, any Claim, including any Action relating to a claim for indemnification or advancement brought by an Indemnified Party as contemplated in Section 7.5.

  • Claim Amount means the amount calculated in accordance with Section 6.2 of this Policy.

  • Expected Claim Notice means a notice that, as a result of a legal proceeding instituted by or written claim made by a third party, an Indemnified Party reasonably expects to incur Damages for which it is entitled to indemnification under Article VII.

  • Royalty Payment has the meaning set forth in Section 6.1.

  • Deficiency Claim Amount has the meaning set forth in Section 5.5(a).

  • Interim Payment has the meaning specified in Section 10.1.

  • Earnout Amount has the meaning set forth in Section 2.7(a).

  • Damage Payment means the dollar amount equal to the amount to be posted as Project Development Security pursuant to Section 8.4(a)(i) hereof.

  • Earn-Out Payment has the meaning set forth in Section 2.5(a).

  • Claim Period means the period of time during which a Settlement Class Member must submit a Claim Form to be eligible to receive a Cash Benefit or Billing Credit Option as part of the Settlement. The Claim Period shall commence not later than thirty (30) days after the Preliminary Approval Date, as defined herein, and shall conclude not more than ninety (90) days after it commences.

  • Closing Payment has the meaning set forth in Section 2.2(a).

  • Contingent Payment means any payment that has been (or is required to be) ------------------ made under any of the following circumstances:

  • Delta Payment means as it is described in this Agreement.

  • Upfront Payment has the meaning set forth in Section 4.1.

  • Tax Claim has the meaning set forth in Section 6.05.

  • Claim Determination Period means a calendar year. However, it does not include any part of a year during which a person has no coverage under This Plan, or any part of a year before the date this COB provision or a similar provision takes effect.

  • Disputed Claim means any Claim that is not Allowed.

  • Unpaid estimated income tax means estimated income tax due but not paid by the date the tax is required to be paid under applicable law.

  • Warranty Claim means a claim for breach of any of the Warranties.