Denied claim means a claim for compensation which an insurer or self-insured employer refuses to pay on the express ground that the injury or condition for which compensation is claimed is not compensable or otherwise does not give rise to an entitlement to any compensation or a claim under ORS 656.386(1)(b)(B), (C) or (D) to which the insurer or self-insured employer does not timely respond.
Denied claim means any claim line for which the Allowed Amount equals $0. Denied Claims are not included in this Settlement.
Denied claim means the insurer refuses to pay a claim for any reason except for failure to meet the waiting period or due to an applicable preexisting condition.
Examples of Denied claim in a sentence
No. 1337 Denied claim and referred to District’s insurance carrier.
Denied claim that is not cured within MHESLA's specified time period (See Section 1.022-A Task 9e).
Denied claim - received and processed by the payer and deem unpayable.
Denied claim that is not cured within MFA's specified time period as mentioned above.
Denied claim or line item: A denied claim or line item is one the claim processing system has accepted and reviewed, and a state has made a final decision not to pay the claim or line item in whole or in part.
More Definitions of Denied claim
Denied claim means any claim line for which the Allowed Amount equaled $0. Without limitation of the foregoing, and by way of example only, if a provider’s request for reimbursement from the Company reflects several CPT codes or services that the Company “bundles” in connection with reimbursement – e.g., a particular CPT code or service is not reimbursed separately because it is deemed by the Company to be incidental to or included in another service that the Company reimburses – the CPT code or service that is not reimbursed separately by the Company is considered a Denied Claim.
Denied claim means a clean claim or a portion of a clean claim for which a determination is made that the claim cannot be paid. Disability means a physical or mental impairment that substantially limits one or more of the major life activities of an individual. Disability-related access means that facilities are readily accessible to and usable by individuals with disabilities, and that auxiliary aids and services are provided to ensure effective communication, in compliance with Title III of the Americans with Disabilities Act.
Denied claim or “DISALLOWED CLAIM” means (1) any Claim
Denied claim. A claim for which no payment is made to a provider by the Contractor for any of several reasons, including but not limited to, the claim is for non-MCO covered services, an ineligible provider or enrollee, is a duplicate of another transaction, or has failed to pass a significant requirement in the claims processing system.
Denied claim means a clean claim or a portion of a clean claim for which a determination is made that the claim cannot be paid.
Denied claim. An adjudicated claim that does not result in a payment obligation to a provider.
Denied claim means a clean claim or a portion of a clean claim for which a determination is made that the claim cannot be paid. Disability means a physical or mental impairment that substantially limited one or more of the major life activities of an individual. DSM-IV means the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, which is the American Psychiatry Association's official classification of behavioral health disorders.