Service Claim definition

Service Claim means any Claim for benefits under this Contract for which, in whole or in part, a Claimant must obtain authorization from AvMed in advance of such services being provided to or received by the Member.
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Service Claim means any Claim for benefits under this Contract that is not a Pre-Service Claim.
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Service Claim means any debt or sum required to make good any loss, deficiency or irregular expenditure of service money pertaining to any service mess, club, institution or other service organization for which, after due investigation, no explanation satisfactory to the Minister is given by the person responsible for the same; and
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Examples of Service Claim in a sentence

  • Within 60 days after receipt of the grievance for a case involving a Post- Service Claim; and In the case of an expedited appeal regarding a claim relating to a prescription for the alleviation of cancer pain, the appeal decision shall be made as soon as possible but no later than 24 hours after receipt of the appeal.

  • These areservices that must be "preauthorized" or "precertified" by CareFirst BlueChoice under the terms of the Member's contract.Post Service Claim means any claim for a benefit that is not a Pre-Service Claim.Rescission means, as used in this attachment, a cancellation or discontinuance of coverage that has retroactive effect, except to the extent it is attributable to a failure to pay required premiums or contributions towards the cost of coverage.

  • Within 30 days after receipt of the grievance for a case involving a Pre- Service Claim; b.

  • The form will give You instructions for filing the Post- Service Claim.

  • These are services that must be "preauthorized" or "precertified" by CareFirst under the terms of the Member's contract.Post Service Claim means any claim for a benefit that is not a Pre-Service Claim.Rescission means, as used in this attachment, a cancellation or discontinuance of coverage that has retroactive effect, except to the extent it is attributable to a failure to pay required premiums or contributions towards the cost of coverage.

  • We will deny any Post- Service Claim not received within this time limit.

  • In-Network or Participating Providers will file Your Post- Service Claim for You.

  • Some Out-of-Network Providers that are Non-Participating will submit Your Post- Service Claim for You.

  • If an Out-of- Network Physician who is Non-Participating declines to file Your Post-Service Claim for You, You can obtain a Post- Service Claim form from Our Customer Service Department.

  • You may submit a Post- Service Claim if You are asked to pay the full cost of the prescription drug when You fill it and You believe that the Plan should have paid for it or You believe that the Co- payment amount was incorrect.


More Definitions of Service Claim

Service Claim means any service debt or sum required to make good any loss, deficiency or irregular expenditure of service money of which, after due investigation, no explanation satisfactory to the Defence Board is given by the person who is responsible for the same;
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Service Claim has the meaning ascribed to such term in Section 8.14(a) hereof.
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Related to Service Claim

  • Pre-Service Claim means a claim for a medical care benefit with respect to which the plan conditions receipt of the benefit, in whole or in part, on approval of the benefit in advance of receipt of care.

  • Post-Service Claim means a claim for payment for medical care that already has been provided.

  • Cure Claim means a Claim (unless waived or modified by the applicable counterparty) based upon a Debtor’s defaults under an Executory Contract or an Unexpired Lease assumed by such Debtor under section 365 of the Bankruptcy Code, other than a default that is not required to be cured pursuant to section 365(b)(2) of the Bankruptcy Code.

  • Rejection Claim means a Claim arising from the rejection of an Executory Contract or Unexpired Lease pursuant to section 365 of the Bankruptcy Code.

  • Urgent Care Claim means a claim for medical care or treatment where making a non-urgent care decision: (a) could seriously jeopardize the life or health of the claimant or the ability of the claimant to regain maximum function, as determined by an individual acting on behalf of the plan applying the judgment of a prudent layperson who possesses an average knowledge of health and medicine; or (b) in the opinion of a physician with knowledge of the claimant’s medical condition, would subject the claimant to severe pain that cannot be adequately managed without the care.

  • Convenience Claim means a Claim that would otherwise be an Other Unsecured Claim that is

  • Preference Claim As defined in Section 4.02 hereof.

  • Service Call A visit to Your Residence by one of HomeServe’s approved local technicians, where work is performed to diagnose and complete a single repair, or where it is determined the repair is not covered.

  • AWR Claim means any complaint or claim to a tribunal or court made by or on behalf of the Agency Worker against the Hirer and/or the Employment Business for any breach of the AWR;

  • Third Party Claim has the meaning set forth in Section 8.3.

  • Tax Claim has the meaning set forth in Section 6.05.

  • 503(b)(9) Claim means a Claim or any portion thereof entitled to administrative expense priority pursuant to section 503(b)(9) of the Bankruptcy Code.

  • Relevant Claim means a civil claim made in respect of any of the following—

  • Disputed Claim means any Claim that is not Allowed.

  • IPR Claim means any claim of infringement or alleged infringement (including the defence of such infringement or alleged infringement) of any IPR, used to provide the Services or as otherwise provided and/or licensed by the Supplier (or to which the Supplier has provided access) to the Authority in the fulfilment of its obligations under this Framework Agreement;

  • 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 Person Claim has the meaning specified in Section 11.4(a).

  • Payment Initiation Service Provider or “PISP” means an authorised third party provider which provides a service that allows that third party to pass payment instructions to us on your behalf in relation to your Account.

  • Toll Billing Exception Service (TBE means a service that allows End Users to restrict third number billing or collect calls to their lines.

  • Billing Party means the Party rendering a bill.

  • Claim means any claim, action, cause of action, demand, lawsuit, arbitration, inquiry, audit, notice of violation, proceeding, litigation, citation, summons, subpoena, or investigation of any nature, whether civil, criminal, administrative, regulatory or other, and whether at law, in equity or otherwise brought against an Indemnified Person.

  • Dispute means any dispute, controversy, claim or difference of whatever nature arising out of, relating to, or having any connection with this Agreement, including a dispute regarding the existence, formation, validity, interpretation, performance or termination of this Agreement or the consequences of its nullity and also including any dispute relating to any non-contractual rights or obligations arising out of, relating to, or having any connection with this Agreement.

  • Professional Fee Claim means a Claim by a professional seeking an award by the Bankruptcy Court of compensation for services rendered or reimbursement of expenses incurred through and including the Confirmation Date under sections 330, 331, 503(b)(2), 503(b)(3), 503(b)(4), or 503(b)(5) of the Bankruptcy Code.

  • Clean Claim means a claim that:

  • Professional Claim means an Administrative Claim of a Professional for compensation for services rendered or reimbursement of costs, expenses, or other charges and disbursements incurred relating to services rendered or expenses incurred after the Petition Date and prior to and including the Confirmation Date.

  • Service Outage means an instance when the Customer is unable to route traffic to one or more Customer Sites via the Network, which results in Service Downtime;