Claims Generally. Network Providers will file claims directly with the Plan. Members may need to submit a claim for reimbursement for services from a Non-Network Provider. Time Limits for Post-Service Claims: Health Options must receive a claim within 120 days after receiving a service or item covered by the Plan or as soon as reasonably possible after the 120 days if it is not reasonably possible to submit notice within the 120 days. A claim sent to Community Health Options® at 000 Xxxx Xx, 0xx Xxxxx, Xxxxxxxx, XX 00000, or to any authorized agent of Health Options, with information sufficient to identify the Member, shall be deemed notice to Health Options. You may obtain a medical or prescription drug claim form at xxx.xxxxxxxxxxxxx.xxx or by calling Member Services at 1-855-624-6463 (TTY/TDD: 711). The form will include instructions on what information you will need to submit to the Plan so that the Plan can make a decision on the claim. Please return the completed claim form along with copies of any receipts or invoices to the address on the form. If we do not furnish these forms to you within 15 days after we receive your request, you may meet the proof requirements by giving us a written statement of the nature and extent of the claim within 120 days after the service is rendered. Benefits will be paid to the Member who received the services for which a claim is made unless the Member is a minor. In this case, Benefits will be paid to the parent or custodian with whom the minor resides. The Member may authorize Health Options to pay Benefits directly to the Provider who charged for the service subject to the claim. Any payment made by Health Options in accordance with the terms of this Agreement will discharge Health Options from all further liability to the extent of such payment.
Claims Generally. Network Providers will file claims directly with the Plan. Members may need to submit a claim for reimbursement for services from a Non‐Network Provider.
Claims Generally. Network Providers will file claims directly with the Plan. In the event that a Member receives services from a Non-Network Provider, Members may submit a claim for reimbursement for services from a Non-Network Provider. Coverage is not guaranteed. Time Limits for Post-Service Claims for services from a Non-Network Provider: Community Health Options must receive a claim within 120 days after receiving a service or item covered by the Plan or as soon as reasonably possible after the 120 days if it is not reasonably possible to submit notice within the 120 days. A claim sent to Community Health Options at; XX Xxx 0000, Xxxxxxxx, XX 00000 or to any authorized agent of Community Health Options, with information sufficient to identify the Member, shall be deemed notice to Community Health Options. You may obtain a medical claim form or an Express Scripts prescription reimbursement form at xxx.xxxxxxxxxxxxx.xxx or by calling Member Services. The forms will include instructions on what information you will need to submit to the Plan so that the Plan and/or Express Scripts can make a decision on the claim. Please return the completed claim form along with copies of any receipts or invoices to the address on the form. If we do not furnish these forms to you within 15 days after we receive your request, proof requirements will have been met upon receipt of your written statement of the nature and extent of the claim within 120 days after the service is rendered. Any payment made by Community Health Options in accordance with the terms of this Agreement will discharge Community Health Options from all further liability to the extent of such payment.
Claims Generally. Notwithstanding anything to the contrary contained herein, each party hereby agrees not to initiate any claim under this Agreement (and, for the avoidance of doubt, no third party beneficiary to any provision of this Agreement shall have the right to initiate any claim under this Agreement) at any time after the sixth (6th) anniversary of the Closing Date.
Claims Generally. (a) If at any time a Buyer Indemnified Person is entitled to Indemnification under Article IX or shall become aware of any state of facts that has resulted or may result in a Claim for Damages, the Buyer Indemnified Person shall (i) give written notice to the Shareholders Representative pursuant to and otherwise follow the procedures set forth in the Escrow Agreement and (ii) follow the procedures set forth in paragraphs (b) through (e) below.
Claims Generally. (a) If at any time an indemnified party is entitled to indemnification under Article VIII or shall become aware of any state of facts that have resulted or may result in a claim for Damages, and if Buyer is the Indemnified Person and the Escrow Amount is still being held by the Escrow Agent pursuant to the Escrow Agreement, the indemnified party shall give written notice to Seller pursuant to and otherwise follow the procedures set forth in the Escrow Agreement. If at any time an Indemnified Person is entitled to indemnification under Article VIII or shall become aware of any state of facts that have resulted or may result in a claim other than against the Escrow Amount, the Indemnified Person shall then follow the procedures set forth in (b) through (e) below.
Claims Generally. For the purposes of this Agreement, "Claims" shall mean and include claims with respect to any of the following: (i) breach of contract; (ii) discrimination, retaliation, or constructive or wrongful discharge; (iii) lost wages, lost employee benefits, physical and personal injury, stress, mental distress, or impaired reputation; (iv) claims arising under the Age Discrimination in Employment Act ("ADEA"), Title VII of the Civil Rights Act, the Equal Pay Act, the Americans with Disabilities Act, the Family and Medical Leave Act, or any other federal, state or local laws or regulations prohibiting employment discrimination; (v) attorneys' fees; and (vi) any other claim arising from or relating to Zunkxx'x xxxloyment with the Company and/or the Zunkxx'x xxxirement from the Company.
Claims Generally
