Claims Determination as used in this Agreement means the acknowledgement, adjudication, adjustment, denial, contest, payment, and/or any other action by Health Plan following Provider’s submission of a claim for reimbursement under this Agreement, including without limitation Health Plan’s failure to pay or otherwise take required action with respect to such claims.

Claims Determination as used in this Agreement means the acknowledgement, adjudication, adjustment, denial, contest, payment, and/or any other action by Blue Shield following Provider’s submission of a claim for reimbursement under this Agreement, including without limitation Blue Shield’s failure to pay or otherwise take required action with respect to such claims.

Claims Determination means either, (i) the Escrow Agent shall have received a final and non-appealable order of a court of competent jurisdiction or a final written award of arbitrators as to the disposition of the Claim Amount in the Indemnity Claim Notice, or (ii) the Escrow Agent has received written notice prepared in accordance with Section 4(f) hereof signed by Authorized Representatives of the Representative and the Buyer as to the disposition of the Claim Amount set forth in the Indemnity Claim Notice, at which time (and in any event within one Business Day after receipt of such joint written instructions or final court order and award and accompanying certification) the Escrow Agent shall release to the Buyer or retain, as applicable, such Claim Amount in accordance with such written notice or final court order or award.

Examples of Claims Determination in a sentence

The parties further acknowledge and agree that this Section 8.4 shall not apply to controversies or disagreements that arise out of or relate to a Claims Determination, or to Claims Overpayments, or to Final Claims Overpayment Determinations, or to any claims of medical malpractice, breach of privacy or HIPAA obligations, or intellectual property claims.
The parties agree that the terms and conditions set forth in this Section 8.1 shall apply to all disputes relating to or arising out of a Claims Determination.
If Provider desires to dispute a Claims Determination, it shall submit a written appeal that contains all of the information set forth in the applicable Provider Manual (“Provider Appeal”) and is completed by Provider pursuant to the timelines and procedural requirements delineated in the Provider Manual.

More Definitions of Claims Determination

Claims Determination means, with respect to a claim by Buyer for payment or indemnification under the Purchase Agreement, (x) a written compromise or settlement of such claim signed by Buyer and the Shareholders specifying an amount owing, if any, to Buyer, (y) a Final Order in favor of Buyer and against one or more of the Shareholders with respect to such claim, or (z) a Final Order in favor of one or more of the Shareholders and against Buyer with respect to such claim.

SOFR Determination Time means 3:00 p.m. (New York time) on the U.S. Government Securities Business Day, at which time Compounded SOFR is published on the FRBNY’s Website.
Final Determination Date means the following:
Initial determination means the first child custody determination concerning a particular child.
Dividend Determination Date means, for the purposes of the definition of “Dividend”, the date on which the number of Ordinary Shares or, as the case may be, amount of other property or assets, which may be issued or delivered is, or is capable of being, determined, and where determined by reference to prices or values or the like on or during a particular day or during a particular period, the Dividend Determination Date shall be deemed to be such day or the last day of such period, as the case may be;
Disputed Claim means any Claim that is not Allowed.