Provider Claim definition
Examples of Provider Claim in a sentence
When seeking reimbursement from HPN for expenses incurred in connection with services received from Non-Plan Providers, the Member must complete a Non-Plan Provider Claim Form and submit it to the HPN Claims Department with copies of all of the medical records, bills and/or receipts from the Provider.
If the Member receives a bill for Covered Services from a Non-Plan Provider, the Member may request that HPN pay the Provider directly by sending the bill, with copies of all medical records and a completed Non-Plan Provider Claim Form to the HPN Claims Department.
Non-Plan Provider Claim Forms can be obtained by contacting the Member Services Department at (702) 242- 7300 or ▇-▇▇▇-▇▇▇-▇▇▇▇.
The Contractor’s dispute process for subcontractors and non-contracted providers includes a claim dispute process and access to the State’s fair hearing process as outlined in Attachment F2, Provider Claim Dispute Standards.
Non-Plan Provider Claim Forms can be obtained by calling the Member Services Department at ▇-▇▇▇-▇▇▇-▇▇▇▇.
Non-Plan Provider Claim Forms can be obtained by calling the Member Services Department at ▇▇▇-▇▇▇-▇▇▇▇.
In the case of any Brokerage Service Provider Claim commenced and prosecuted by Licensor, Licensee shall reimburse Licensor for such fees and expenses as incurred.
The Contractor shall remain responsible for compliance with all requirements set forth in Attachments F1, Enrollee Grievance System Standards, F2, Provider Claim Dispute Standards, and 42 CFR Part 438 Subpart F.
Holdings shall, and shall cause each Licensor Affiliate to, reasonably cooperate with and provide reasonable assistance to Licensee in connection with such Brokerage Service Provider Claim, at Licensee’s expense.
Such notice shall provide the name of each eligible Beneficiary within the group and the amount of each such Beneficiary's Provider Claim or Plan Preserved Claim or the provision of the Agreement that such Representative is seeking to enforce.