Examples of Claims Administrators in a sentence
To locate an approved transplant facility, Plan Participants should contact the Claims Administrator's customer service department at the number listed on their ID card.
The Claims Administrators also have a process to resolve complaints.
The Claims Administrators will provide the IRO with the documentation.
GuideStone, the Claims Administrators, and the applicable IRO have the power, including, without limitation, discretionary power, to make all determinations that the Plan requires for its administration, and to construe and interpret the Plan whenever necessary to carry out its intent and purpose and to facilitate its administration, including, but not by way of limitation, the discretion to grant or deny claims for benefits under the Plan.
Your information may be passed to Now Health group companies administrating Your Plan, Underwriters, Insurers, Reinsurers, Medical Practitioners, Medical Assistance Companies and Claims Administrators for these purposes, including those located outside Your country of residence.
Plan Participants may review a current paper Provider directory, check on-line at www.bcbsla.com, or contact the Claims Administrator's customer service department at the number listed on their ID card.
The second level appeal will take place and you will be notified of the decision within 30 days from receipt of a request for review of the first level appeal decision.Please note that the Claims Administrator's decision is based only on whether or not Benefits are available under the Plan for the proposed treatment or procedure.You may have the right to external review through an Independent Review Organization (IRO) upon the completion of the internal appeal process.
In order to remove any bias and ensure independence, the Claims Administrators for the medical and prescription drug components of the Plan will each contract with at least 3 IROs on behalf of the Plan and will incorporate an independent, unbiased method for assigning claims to the IROs. The IRO will not be eligible for any financial incentives based on the likelihood that it will support the denial of benefits.
The Copayments, annual Deductibles and Coinsurance amounts You pay for medical services will vary depending upon the Cost Level to which Your PCC belongs.Members may change Claims Administrators only during the annual open enrollment period or because of a status change permitted by law.
Your information may be passed to Now Health group companies administering Your Plan, Underwriters, Medical Practitioners, Medical Assistance Companies and Claims Administrators for these purposes, including those located outside Singapore.