Submission of Claims. 39 If Provider submits claims for Services rendered under this Contract, the following 40 requirements shall apply:
Submission of Claims. The Administrator shall prepare and submit any claim under the Insurance Policies in accordance with the requirements of the relevant Insurance Policy and otherwise with the usual procedures undertaken by a reasonable and prudent mortgage lender on behalf of the Mortgages Trustee as trustee for the Beneficiaries and shall comply with the other requirements of the insurer under the relevant Insurance Policy.
Submission of Claims. Whenever any Proceeding shall occur as to which indemnification under this Agreement may be sought by the Indemnitee, the Indemnitee shall give the Corporation written notice thereof as promptly as reasonably practicable after the Indemnitee has actual knowledge of such Proceeding (an "Indemnification Notice"). The Indemnification Notice shall specify in reasonable detail the facts known to the Indemnitee giving rise to such Proceeding, the positions and allegations of the parties to such Proceeding and the factual bases therefor, and the amount or an estimate of the amount of Liabilities and Expenses reasonably expected to arise therefrom. A delay by the Indemnitee in providing such notice shall not relieve the Corporation from its obligations under this Agreement unless and only to the extent that the Corporation is materially and adversely affected by the delay. If the Indemnitee desires to personally retain the services of an attorney in connection with any Proceeding, the Indemnitee shall notify the Corporation of such desire in Indemnification Notice relating thereto, and such notice shall identify the counsel to be retained.
Submission of Claims. When Services are provided to a Covered Person, the Covered Person shall inform the Provider that he or she is a Covered Person of Company. In the case of a Participating Provider, the Covered Person is not responsible for filing the claim. In the case of a Non-Participating Provider, the Covered Person must file a claim for reimbursement unless the Provider agrees to file a claim on the Covered Person's behalf. Company shall not be obligated to make any payment until it receives, reviews and approves a claim for payment.
Submission of Claims. Except as otherwise provided in Section 7.04, Participants shall make claims for reimbursements under the Plan in writing following such procedures, including deadlines and documentation requirements, and using such forms, as are prescribed by the Plan Administrator. Claims which are approved by the Plan Administrator shall be paid no less frequently than monthly or as soon thereafter as administratively feasible. Participants may file claims for expenses incurred during a Plan Year until the date specified in the Adoption Agreement following the end of the Plan Year.
Submission of Claims. Doctor shall submit claims and other required information in the form and within the timeframes set forth in accordance with the procedures as stated in the applicable Plan Summary, or applicable Rules or Regulations. Claims submission procedures may be changed at any time at the discretion of CCMI, its designee or a health plan company. Standard claim forms (e.g. CMS 1500) shall be used for claims. Doctor understands that claims may be returned unpaid to Doctor for failure to follow correct submission procedures. Doctor further understands that an Enrollee may not be charged or billed for any charges denied because of late submission of claims by Doctor and that all such charges must be waived by Doctor.
Submission of Claims. Either You or the Provider of service must claims benefits by sending Xxxxx properly completed claims forms itemizing the services or supplies received and the charges. These claim forms must be received by Xxxxx within one hundred eighty (180) from the date of services or supplies are received. If the claim is for an Out-of-Network Emergency Center or Urgent Care Center, these claim forms must be received by Oscar within one-hundred eighty (180) days from the date of services. Xxxxx will not be liable for benefits if a completed claim form is not furnished to Oscar within this time period, except in the absence of legal capacity. Claims forms must be used, canceled checks or receipts are not acceptable. Xxxxx follows all Department of Managed Health Care regulations when it comes to the payment of claims. Please submit Your claims as soon as possible in order to expedite payments. Any benefits determined to be due under this Agreement shall be paid within thirty (30) working days after We receive a complete written proof of loss and determination that benefits arepayable. When using an In-Network Provider they will bill Oscar directly for services rendered to You. In order for the Provider to submit a claim on Your behalf, You must give the Provider information necessary for the claim to be filed, such as Your Oscar ID card. Contracted providers must submit claims within one hundred eighty (180) calendar days following the dates of service, unless otherwise mandated by law or in the provider contract. A claim received after the one hundred eighty (180) days billing time limit may be subject to a denial. After You get Covered Services for Out-of-Network Emergency or Urgent Care, We must receive written notice of Your claim within one-hundred eighty (180) days, or as soon thereafter as reasonably possible. Either the Subscriber or Provider of service must claim benefits by sending Us properly completed claim forms itemizing the services or supplies received and the charges. These claim forms must be received by Us within one- hundred eighty (180) calendar days from the date the services or supplies are received. We will not be liable for benefits if We do not receive completed claim forms within this time period. Claim forms must be used; canceled checks or receipts are not acceptable. Claim forms are available by accessing Our web site at xxx.xxxxxxx.xxx by calling the telephone number on the back of Your Identification Card or by writing to Us at the addr...
Submission of Claims. At any time prior to the expiration of the Claims Period, members of the Settlement Class may submit a Claim Form to the Settlement Administrator by mail or through the settlement website pursuant to the directions on the Claim Form.
Submission of Claims. Provider shall submit Claims to Avesis in a timely manner as described in Section G. Provider understands that failure to submit Clean Claims or requested documentation within the specified time period as outlined in the Provider Manual may result in loss of reimbursement for services provided. Claim disputes will be referred to the Avesis Chief Dental Officer and, if not settled, shall fall under Section O. of this Agreement.
Submission of Claims. 8.1 For a Settlement Class Member to be paid from the Net Settlement Fund, he or she must complete and timely submit a Claim Form certifying the Settlement Class Member’s entitlement to make a claim. The Claim Form shall be deemed deficient by the Claims Administrator if it is not fully completed and signed and, accordingly, will be rejected upon receipt subject to the ability to cure the deficiency as described in Section 8.6 below.
8.2 The Claims Administrator will develop and post an online version of the Claim Form (Exhibit D) that may be “certified” and submitted electronically.
8.3 An individual Settlement Class Member may contact the Claims Administrator before submitting a Claim Form to ask how many qualifying calls are shown for him or her on the Settlement Class Member Contact List. A Settlement Class Member may dispute the number of telephone calls associated with his or her telephone number or numbers by contacting the Claims Administrator to submit a dispute. Detailed instructions on how to submit a dispute regarding the number of qualifying calls will be provided on the Settlement Website, including in the long-form Settlement Class Notice (Exhibit C). The Claims Administrator may require individual Settlement Class Members to provide proof of their telephone calls to or from Defendant during the Class Period. All disputes must be submitted by the deadline to submit a claim; provided, however, that if an individual requests an extension of time to submit a dispute, the Claims Administrator shall review that request with Class Counsel and Counsel for Defendant and decide whether the request for additional time will be granted and promptly shall communicate the resulting decision to the Settlement Class Member who made the request. The Claims Administrator shall make a final and binding resolution of any disputes submitted under this Section 8.3.
8.4 Each Settlement Class Member who submits a Claim Form will be required to provide a unique code. The code will be provided on the Postcard Notice and the Email Notice (Exhibits A and B, respectively). Settlement Class Members also may obtain the required code by contacting the Claims Administrator by telephone or email, as described in the notices and as posted on the Settlement Website.
8.5 In order to receive a share of the Net Settlement Fund, a Settlement Class Member must complete and timely submit a Claim Form, and that Claim Form must be validated by the Claims Administrator as provided in S...
