Third Party Claims Administrator definition

Third Party Claims Administrator means the organization under contract to the Board responsible for processing all medical claims, other than claims for prescription drug services, received from participants.
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Third Party Claims Administrator means the third party retained by GAF, who will, at GAF’s direction and request, assist GAF with the initial intake of claims, including (i) answering telephone calls, (ii) monitoring and responding to email and website requests, (iii) mailing Claims Kits, (iv) receiving claim forms and supporting documentation, (v) assigning claim numbers, (vi) reviewing claims for completeness (i.e., verifying that a claim includes the documentation and materials required under Section 7 of the Agreement) and (vii) sending Deficiency Notices.
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Third Party Claims Administrator or “TPA” means a third party firm contractually responsible for performing professional claims adjusting and other ancillary risk management services for the Port Authority.
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Examples of Third Party Claims Administrator in a sentence

  • The Third Party Claims Administrator will be expected to perform its services in accordance with the requirements of any regulatory authority having jurisdiction as well as any applicable State, Federal or Local law.

  • Registration of Claims: Covered individuals shall submit claims to the Third Party Claims Administrator (TPA) retained by the Commission.

  • The Plan is a self-funded group health Plan and the administration is provided through a Third Party Claims Administrator.

  • I also understand that the Plan Administrator and Third Party Claims Administrator may establish rules and procedures from time to time, which also govern processing reimbursement requests.

  • Develop metrics for student support services (July 2014 and ongoing) ROICom Flow Promotion Strategies Design and implement prospective and new student communication flow targeted to specific populations—domestic first year and transfer, international first year and transfer, veterans, Native American, online, adult learners1.1 To work within Hobsons to create a cohesive targeted communications flow for each subpopulation1.

  • Third Party Claims Administrator must immediately send you a notice of its eligibility determination.

  • Within one (1) business day after making the decision, the IRO must notify you, Third Party Claims Administrator and the Plan.

  • Even if you contract with a Service Organization (Third Party Claims Administrator) to handle the administration, investigation or settlement of any loss or “claim” covered under this policy, you are still ultimately responsible for compliance with such laws.

  • Immediately upon receipt of the request for expedited Independent Review, Third Party Claims Administrator will determine whether the request meets the reviewability requirements set forth above for standard External Review.

  • Finance staff monitors the Town’s Third Party Claims Administrator (CIRMA) to insure, on a quarterly basis, that all contractual performance standards and requirements are met 95% of the time.

Related to Third Party Claims Administrator

  • Claims Administrator means the firm proposed by Class Counsel and appointed by the Courts to administer the Settlement Amount in accordance with the provisions of this Settlement Agreement and the Distribution Protocol, and any employees of such firm.

  • Third party claimant means any individual, corporation, association, partnership, or other legal entity asserting a claim against any individual, corporation, association, partnership, or other legal entity insured under an insurance policy or insurance contract.

  • Third Party Claim has the meaning set forth in Section 7.05(a).

  • Claims Administration means the processing of claims made under the Shared Policies, including the reporting of claims to the insurance carriers, management and defense of claims and providing for appropriate releases upon settlement of claims.

  • First party claimant means an individual, corporation, association, partnership or other legal entity asserting a right to payment under an insurance policy or insurance contract arising out of the occurrence of the contingency or loss covered by such policy or contract;

  • Third Party Claim Notice shall have the meaning set forth in Section 6.5(a).

  • Notice and Claims Agent means Prime Clerk LLC.

  • Third Party Claims has the meaning set forth in Section 11.1.

  • Claims Agent means Kurtzman Carson Consultants LLC.

  • Review Panel means the panel, if any, appointed pursuant toRule 710 to review a completed Investigation Report and to determine whether a reasonable basis exists for finding a violation of the Rules and authorizing the issuance of a notice of charge pursuant to Rule 706.

  • Third Party Administrator (TPA means any organization or institution that is licensed by the IRDA as a TPA and is engaged by the Company for a fee or remuneration for providing Policy and claims facilitation services to the Insured / Insured Person as well as to the Company for an insurable event.

  • Third party administrator means an administrator operating under a certificate of authority issued by the commissioner pursuant to the third party administrator act.

  • Appeals Panel means a panel appointed by the Chief Compliance Officer pursuant to Rule 620.

  • Direct Claim has the meaning set forth in Section 8.05(c).

  • Indemnifying Party shall have the meaning set forth in Section 5(c).

  • Joint Remediation Committee has the meaning set forth in Section II.A.2.

  • Claim for Benefits means a request for a Plan benefit or benefits made by a Member in accordance with the Plan’s Appeals Procedures, including any Pre-Service Claims (requests for Prior Authorization) and Post-Service Claims (requests for benefit payment).

  • Appeals Committee means a Committee or Tribunal duly appointed by by-law to conduct hearings under this by-law;

  • Claims Notice has the meaning set forth in Section 9.3(a).

  • CFD Administrator means an official of the City, or designee thereof, responsible for determining the Special Tax Requirement and providing for the levy and collection of the Special Taxes.

  • Plan Administrator means the plan administrator described in Article 8.

  • Third Party IP Claim has the meaning given to it in clause E8.7 (Intellectual Property Rights).

  • Indemnified Party shall have the meaning set forth in Section 5(c).

  • Third Party Infringement Claim has the meaning set forth in Section 5.4.

  • Claim Form or “Proof of Claim Form” means the form, substantially in the form attached hereto as Exhibit 2 to Exhibit A, that a Claimant or Settlement Class Member must complete and submit should that Claimant or Settlement Class Member seek to share in a distribution of the Net Settlement Fund.

  • Claimant means a person who believes that he or she is being denied a benefit to which he or she is entitled hereunder.