Clean Claim definition

Clean Claim means a claim that:

Clean Claim means a claim (i) that has no material defect or impropriety (including any lack of any

Clean Claim means a claim received by an insurer for

Examples of Clean Claim in a sentence

• A Provider submits a Clean Claim by providing the required data elements on the standard claims forms, along with any attachments and additional elements or revisions to data elements, attachments and additional elements, of which the Provider has knowledge.

• Once treatment is rendered, a Clean Claim must be filed with the Plan (which will be a “Post-service Claim”).

• A Clean Claim does not include a claim submitted by a provider more than 30 days after the date of service, or if the provider does not submit the claim on Your behalf, a claim submitted more than 30 days after the date the provider bills You.

• A claim will not be considered to be a Clean Claim if the Plan Participant has failed to submit required forms or additional information to the Plan as well.

• A claim will not be considered to be a Clean Claim if the Participant has failed to submit required forms or additional information to the Plan as well.

More Definitions of Clean Claim

Clean Claim means clean claim as defined in 2001 Iowa Acts, chapter 69, section 8(2b).

Clean Claim means a claim that has no defect or impropriety, including any lack of required substantiating documentation, such as satisfactory evidence of expenses incurred, or particular circumstance requiring special treatment that prevents timely payment from being made on the claim.

Clean Claim means a claim submitted for payment that has no defect, impropriety, or particular circumstance requiring special treatment preventing payment.

Clean Claim generally means a claim that has no defect, impropriety or special circumstance, including incomplete documentation that delays timely payment.

Clean Claim means a claim that has no defect or

Clean Claim. A claim that has no defect or impropriety including, but not limited to, any lack of any required substantiating documentation or particular circumstance requiring special treatment that prevents timely payment from being made on the claim.

Clean Claim means a claim that (i) identifies the PRACTITIONER that provided the service sufficiently to verify the affiliation status and includes any identifying numbers; (ii) sufficiently identifies that patient is a BCBS member; (iii) lists the date and place of service; (iv) is a claim for Covered Services for an eligible individual; (v) if necessary, substantiates the medical necessity and appropriateness of the service provided; (vi) if prior authorization is required for certain patient services, contains information sufficient to establish that prior authorization was obtained; (vii) identifies the service rendered using an accepted system of procedure or service coding adopted and published by BCBSM; (viii) includes additional documentation based upon services rendered as reasonably required by BCBSM.