Medical claims definition

Medical claims means any statement which conveys the attributes of a product in respect of its therapeutic use, that is, a use for the purpose of or in connection with:

Medical claims means, with respect to any measurement period, the aggregate dollar amount of claims incurred by Affinity with respect to covered medical services provided.

Medical claims means all medical claims, liabilities or other obligations incurred by Cape on or prior to the later of the Closing Date or the Effective Date in connection with the provision of covered health care services to Enrollees.

Examples of Medical claims in a sentence

• How to file In-Network Medical Claims Xxxxx follows all Department of Managed Health Care regulations when it comes to the payment of claims.

• Both Preauthorization and Medical Claims Review use a Medical Necessity and/or Investigational review to determine whether services are covered benefits.

• After the form is completed, send it to Us at: Blue Cross and Blue Shield of Louisiana P.O. Box 98029 Baton Rouge, LA 70898-9029 Other Medical Claims When You receive other medical services (For instance, when You go to clinics or Provider offices), ask if the Provider has contracted with Blue Cross and Blue Shield of Louisiana.

• The Utilization Management Program is a primary resource for the identification of Members for timely and meaningful referral to other Clinical Management Programs and includes Preauthorization and Medical Claims Review.

• Medical Claims Review Xxxxxxxx’s clinicians conduct Medical Claims Review retrospectively through the review of medical records to determine whether the care and services provided and submitted for payment were medically necessary.

More Definitions of Medical claims

Medical claims means any statement which conveys the attributes of a product in respect of its therapeutic use, that is, use for or in connection with:e) preventing, diagnosing, treatment or alleviating a disease, defect or injury in man;f) influencing, inhibiting or modifying a physiological process in man;g) testing the susceptibility of man to a disease or ailment; or destroying or inhibiting micro-organisms that may be harmful to man.

Medical claims means the mechanism by which Members submit for payment their expenses for medical services, also known as “share requests.” This includes health care claims submitted for payment by medical providers to Sharity on behalf of Members.

Medical claims means, with respect to any measurement period, the aggregate dollar amount of claims incurred by the RBC Entities and SWH MA with respect to covered medical services provided prior to the Closing Date.

Medical claims means any statement which expresses the attributes of a medicinal product with respect to

Medical claims means all medical claims, liabilities or other obligations incurred by the Health Insurance Business on or prior to the Effective Time in connection with the provision of covered health care services to Enrollees.

Medical claims means (i) any and all medical claim liabilities of the PHP Group for services to Members related to periods on and before the Closing Date, including, without limitation, IBNR and (ii) any and all claims for inpatient facility services rendered to Members who are admitted to the facility before the Effective Time.

Medical claims means any and all medical claim liabilities of HMO Subsidiary for services to Members, including, without limitation, IBNR.