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).

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.

Claims Processor means Capital Rx or a third-party pharmacy claims processor with which Capital Rx may contract.

Examples of Claims Processor in a sentence

• Accordingly, the Plan will contract with (or direct the Claims Processor to contract with, on its behalf) at least three (3) IROs for assignments under the Plan and rotate claims assignments among them (or incorporate other independent unbiased method for selection of IROs, such as random selection).

• The Claims Processor will determine if enough information has been submitted to enable proper consideration of the claim.

• Medical Records must be annotated in a manner that will aid the Claims Processor in reviewing your claim (e.g. highlighting, flagging, bookmarking etc.).

• Network Pharmacy Providers shall at all times submit Part D Covered Prescription Services to Medicare Drug Plan Members via the POS System to Claims Processor and furnish Part D Covered Prescription Drugs in a manner that permits the Part D Sponsor to comply with Medicare laws and regulations.

• Notwithstanding the above description, the Claims Processor shall make all determinations regarding the awarding of Enhancements through the application of the express terms and requirements of the Master Settlement Agreement and any applicable decisions of the Claims Administrator.

More Definitions of Claims Processor

Claims Processor means a person who underwrites, processes, validates or adjudicates health

Claims Processor means United or a third party pharmacy claims processor with which United may contract.

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.

Claims Processor means a person who underwrites, processes, validates or adjudicates health benefit claims.

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.

Claims Processor means and refer to MAKORX or a pharmacy Claims Processor with which MAKORX 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.

Claims Processor means: NECA-IBEW Family Medical Care Plan office staff.