Claim for Benefits definition

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).

Claim for Benefits means a claim for waiting period or benefits for a designated week.

Claim for Benefits means a request for a Plan benefit or benefits made by an Insured 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).

Examples of Claim for Benefits in a sentence

• The Claims Administrator may request that the Plan Participant or the Provider furnish certain information relating to the Plan Participant’s Claim for Benefits.

• Following the instructions on the Claim for Benefits form will help ensure timely processing of the Member’s Claim for Benefits.

• However, such adjustments will not affect the price Blue Cross Blue Shield of Wyoming has used for the Member’s Claim for Benefits because they will not be applied after a Claim for Benefits has already been paid.

• The Member must submit a Claim for Benefits to obtain reimbursement for Covered Services.

• Estimated pricing and average pricing also take into account adjustments to correct for over‐ or underestimation of past pricing for the Claim for Benefits, as noted above.

More Definitions of Claim for Benefits

Claim for Benefits means a request for one or more benefits which is made by a claimant in accordance with the reasonable procedure for submitting benefit claims offered by an insurance company, nonprofit health services corporation, or health maintenance organization. A reasonable procedure includes an external review procedure that complies with this section.

Claim for Benefits means a request for a Plan benefit made by a Claimant in accordance with the Plan’s reasonable procedures for filing benefit claims under Section 4.04 of this Plan.

Claim for Benefits means any request for a plan benefit or benefits made by a Claimant in accordance with a plan’s reasonable procedures for filing benefit claims.

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

Claim for Benefits means a request for a plan benefit or benefits made by You or Plan Provider in accordance with the Plan’s processing or Appeals Procedures, including any Pre-Service Claims (requests for Prior Authorization) and Post-Service Claims (requests for benefit payment).‌

Claim for Benefits means a request for a Plan benefit or benefits made by a Member in

Claim for Benefits means a request for a Plan benefit or benefits made by a Member in accordance with the Plan’s Appeals