Claims Processor definition

Claims Processor means the Person or Persons from time to time appointed to fulfill the functions of the “Claims Processor” under, and in accordance with the terms of, this Agreement (so long as such Person or Persons continues to serve in such capacity).
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Claims Processor means and refer to SOUTHERN SCRIPTS or a pharmacy Claims Processor with which SOUTHERN SCRIPTS may contract. The Claims Processor shall provide Claims processing, eligibility verification and other mutually agreed upon administrative and reporting services for Plans in connection with the administration of their respective pharmacy benefits.
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Claims Processor means a person who underwrites, processes, validates or adjudicates health
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Examples of Claims Processor in a sentence

  • The Special Master’s determination of such appeal promptly will be communicated by the Claims Processor to the Claims Administrator, HOC, the SOC and the Enrolled Claimant, or his/her Principal Responsible Attorney.

  • The Claims Processor shall periodically report to the Claims Administrator, the SOC, and HOC as set forth in this Agreement and any Administrative Agreement with the Claims Processor.

  • The Claims Processor is The Garden City Group, LLC, or upon its resignation or removal, any Person(s) to be appointed to oversee the administration of claims for benefits.

  • Promptly after the end of each calendar week beginning fourteen (14) Business Days after enrollment in the Settlement Program opens, the Claims Processor shall provide to HOC and the SOC a weekly status report, in such form and in such detail as HOC reasonably from time to time may specify, identifying those Settlement Program Claimants who have qualified for Enhancements together with the amount of each Net QRS-Related Enhancements Benefit.

  • Thereafter, the Claims Processor shall audit an additional five percent (5%) of the Base Award Claims whose enrollment forms were submitted on or after February 2, 2017, unless the Claims Processor finds that two (2%) or more of the first audited claims were fraudulent or improperly processed (or the claimant fails to provide information requested to allow an audit to be conducted) in which case the Claims Processor shall conduct audits of at least an additional ten percent (10%) of Base Award Claims.


More Definitions of Claims Processor

Claims Processor means United or a third party pharmacy claims processor with which United may contract.
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Claims Processor means and refer to Administrator or a third party claims processor with which Administrator may contract, which, in either case, will provide claims adjudication, processing and/or payment of Prescription Claims, eligibility verification of Members (from eligibility data supplied by United or its designee) and/or other administrative and reporting services for United in connection with the administration of the Benefit Plans.
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Claims Processor means a person who underwrites, processes, validates or adjudicates health benefit claims.
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Claims Processor means: Epiq Class Action and Claims Solutions, which shall establish a trust that shall be treated at all times as a “qualified settlement fund” within the meaning of Treas. Reg. § 1.468B-1, et seq. (the “Qualified Settlement Fund” as defined below). References herein to actions and responsibilities of the Claims Processor shall be to those actions and responsibilities it shall take in its position as administrator of the Qualified Settlement Fund.
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Claims Processor means BrownGreer PLC.
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Claims Processor means Capital Rx or a third-party pharmacy claims processor with which Capital Rx may contract.
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Claims Processor means Providence Health Plan.
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