Claim Dispute definition

Claim Dispute means a dispute involving a payment of a claim, denial of a claim, or imposition of a sanction or reinsurance.

Claim Dispute has the meaning ascribed to such term in Section 10.9(a).

Claim Dispute means a dispute, filed by a provider or CONTACTOR as applicable, involving payment of a claim, denial of a claim, or imposition of a sanction.

Examples of Claim Dispute in a sentence

• Your plan premium and your costs for prescription drugs do not count toward your maximumout-of-pocket amount.Combined maximum out-of-pocket amountYour costs for covered medical services (such as copays) from in-network and out-of-network providers count toward your combined maximumout-of-pocket amount.

• The Contractor shall remain responsible for compliance with all requirements set forth in Attachments F1, Enrollee Grievance System Standards, F2, Provider Claim Dispute Standards, and 42 CFR Part 438 Subpart F.

• All claim disputes are adjudicated in Arizona, including those claim disputes arising from claims processed through an administrative services subcontractor.Provider Claim Dispute Acknowledgement and ResolutionWe will send you an acknowledgement letter within 5 business days of receipt of your claim dispute.

• Do not use a Claim Dispute Request Form to submit a corrected claim.

• Contractor Claim Dispute is the Contractor’s dispute of a payment, denial, or recoupment of a claim; the imposition of a sanction; or, the non-payment or partial payment of a performance incentive herein by ADHS.

More Definitions of Claim Dispute

Claim Dispute shall have the meaning set forth in Section 5.07(b).

Claim Dispute means a dispute involving a payment of a claim, denial of a claim, imposition of a sanction or reinsur- ance.

Claim Dispute means a dispute of a payment, denial or recoupment of the payment of a claim, or imposition of a sanction, by ADHS. All Contractor Claim Disputes with ADHS shall be resolved in accordance with the process set forth in the ADHS Policy and Procedures Manual section on Contractor and Provider Claim Disputes.

Claim Dispute has the meaning set forth in Schedule 8.D.

Claim Dispute means any written dispute and supporting evidence submitted by a Claimant pursuant to Paragraph 5(f) of this Agreement.

Claim Dispute has the meaning set forth in Section 10.5(f) of this Agreement.

Claim Dispute means a disagreement involving a payment of a claim, denial of a claim,