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.
Sample 1Sample 2Sample 3
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.
Sample 1
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.
Sample 1

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.

  • The Administrator, Program Manager and Third Party Claims Administrator and such others as required by regulation to do so shall provide Errors & Omissions coverage in a form satisfactory to the Commissioner.

  • The IRO must deliver the notice of Final External Review Decision to you, Third Party Claims Administrator and the Plan.After a Final External Review Decision, the IRO must maintain records of all claims and notices associated with the External Review process for six years.

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

  • Referral of Expedited Review to IROUpon a determination that a request is eligible for External Review following preliminary review, Third Party Claims Administrator will randomly assign an IRO.

  • 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.

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 8.3.

  • Claims Administration means the processing of claims made under the Shared Policies, including, without limitation, the reporting of claims to the insurance carriers and the management of the defense 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.

  • 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).

  • 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).

  • Plan Administrator means the person, persons, and/or third-party administrator designated by the Company to administer the day to day operations of the Plan and the Company’s other equity incentive programs.

  • 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 6.4.

  • 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 must complete and submit should that Claimant seek to share in a distribution of the Net Settlement Fund.

  • Claimant means a person or entity who or which submits a Claim Form to the Claims Administrator seeking to be eligible to share in the proceeds of the Settlement Fund.

  • Claims and Noticing Agent means Stretto, the claims, noticing, and solicitation agent retained by the Debtors in the Chapter 11 Cases by Bankruptcy Court order.

  • Appeal Committee means the appeal committee established by the Council in terms of section 12(3)(a);

  • Review Committee or “Committee” means a committee established pursuant to rule Chapter 67-60, F.A.C.