Common use of Claim Denials Clause in Contracts

Claim Denials. In the event a Claim is denied, PHARMACY will evaluate the cause of denial, as necessary contact pharmacy help desk, and exercise professional judgment to provide service. If the cause of denial cannot be resolved, PHARMACY will notify the Member, refer the Member to Customer Service, if needed, and/or extend an offer to dispense the medication at its U&C price.

Claim Denials. In the event a Claim is denied, PHARMACY will evaluate the cause of denial, as necessary contact pharmacy help desk, and exercise professional judgment to provide service. If the cause of denial cannot be resolved, PHARMACY will notify the Member, refer the Member to Customer Servicecustomer service, if needed, and/or extend an offer to dispense the medication at its U&C price.