Claims Paid definition

Claims Paid means the dollar amount of Wellmark’s payment for Incurred Claims.

Claims Paid means, of the applicable Recognized Charges, the amount payable and paid to Facility by the applicable Payor.

Claims Paid means, for Incurred Claims, the amount for which liability is discharged by Contractor’s payment on behalf of DAS without regard to the Incurred Date. This amount is calculated by deducting from the Covered Charges, any amounts attributable to Provider Savings, deductibles, coinsurance, and Contract Limitations. The amount of Claims Settled during the Rating Period is determined by the date of Contractor’s check or remittance.

Examples of Claims Paid in a sentence

• CALENDAR YEAR 2021 TIMELINE FOR RISK CORRIDOR ACTIVITIES RISK CORRIDOR FUNCTION TENTATIVE TIMELINE Claims Dates of Service January 1, 2021 to December 31, 2021 Claims Paid Date June 30, 2022 Claims Submission Date July 31, 2022 Risk Corridor Calculation September 2022 Risk Corridor Settlement October 2022 APPENDIX F MARKETING AND MEMBER COMMUNICATIONS The following are the MCP responsibilities related to communicating with eligible individuals pre-enrollment and MCP members post-enrollment.

• Facility also agrees, however, that in lieu of or in addition to any such fee that may be charged to Payors, Crescent may charge Facility an administrative fee (limited to no greater than 5% of Claims Paid), as may be determined from time to time by Crescent, as compensation for the administrative services provided to Facility pursuant to Article IX of this Agreement.

• CALENDAR YEAR 2021 TIMELINE FOR RISK CORRIDOR ACTIVITIES RISK CORRIDOR FUNCTION TENTATIVE TIMELINE Claims Dates of Service January 1, 2021 to December 31, 2021 Claims Paid Date June 30, 2022 Claims Submission Date July 31, 2022 Risk Corridor Calculation September 2022 Risk Corridor Settlement October 2022 APPENDIX F MARKETING AND MEMBER COMMUNICATIONS The following are the MCOP’s responsibilities related to communicating with eligible individuals’ pre-enrollment and MCOP members post-enrollment.

• Crescent's agreements with Payor or TPA shall generally state that, except in circumstances that are extraordinary or beyond the control of Facility, all xxxxxxxx by Facility will be considered final unless Facility requests adjustments in writing within ninety (90) days after the Facility receives the applicable Claims Paid with respect to such billing.

• CALENDAR YEAR 2021 TIMELINE FOR RISK CORRIDOR ACTIVITIES RISK CORRIDOR FUNCTION TENTATIVE TIMELINE Claims Dates of Service January 1, 2021 to December 31, 2021 Claims Paid Date June 30, 2022 Claims Submission Date July 31, 2022 Risk Corridor Calculation September 2022 Risk Corridor Settlement October 2022 MILLIMAN CLIENT REPORT Calendar Year 2021 Medicaid Managed Care Provider Agreement Rate Amendment Summary January 1, 2021 through December 31, 2021 Ohio Department of Medicaid July 27, 2021 Xxxxxx X.

More Definitions of Claims Paid

Claims Paid means the amounts paid for the covered employees of an employer by an insurer, health care center, hospital service corporation, medical service corporation or other entity as specified in subsection (b) of this section for medical services and supplies and for prescriptions filled, but does not include expenses for stop-loss coverage, reinsurance, enrollee educational programs or other cost containment programs or features, administrative costs or profit.

Claims Paid means the basis on which benefits may be made available to Members as stated in Rule 6.4;

Claims Paid means all payments made by a health carrier

Claims Paid means a payment made by the INSURER on behalf of the INSURED pursuant to a judgment, or by way of repair or settlement of a CLAIM.

Claims Paid means a dollar amount determined in accordance with statutory annual statement reporting . . . .”506 Residual reserve, in turn, is calculated as 3.3 percent of the combination of paragraphs (i), (iii), and (iv) of the total losses incurred definition.507

Claims Paid. ™ means a “Claim” arising out of an “Occurrence,”

Claims Paid means a dollar amount determined in accordance with statutory annual statement reporting and consistent with N.J.A.C. 11:20-8.5(c), adjusted as required by this subchapter.