Preservice claim definition

Preservice claim means a request for benefits or payment from a health insurance issuer for
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Preservice claim means a request for benefits or payment from a health insurance issuer for health care services that, under the terms of the health insurance issuer's contract of coverage, requires authorization from the health insurance issuer or from the health insurance issuer's designated utilization review organization prior to receiving the services.
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Preservice claim means any claim for a benefit
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Examples of Preservice claim in a sentence

  • If, due to Emergency or urgency as defined above, a Pre-service claim is not possible, the Claimant must comply with the Plan’s requirements with respect to notice required after receipt of treatment, and must file the claim as a Post-service Claim, as herein described.

  • Pre-service claim means the request for a plan benefit(s) by You prior to a service being rendered and is not considered a concurrent claim.

  • Pre-service claim appeals are those requested when you have received a denial of a Pre-Service Claim in advance of you receiving Medical Care.

  • A Pre-service claim (including a Concurrent claim that also is a Pre-service claim) is considered to be filed when the request for approval of treatment or services is made and received by the ASO in accordance with the Plan’s procedures.

  • A Pre-service Claim (including a Concurrent claim that also is a Pre-service claim) is considered to be filed when the request for approval of treatment or services is made and received by the Third Party Administrator in accordance with the Plan’s procedures.

  • Pre-service claim appeals are those requested in advance of obtaining Medical Care for approval of a benefit, as it relates to the terms of the plan Certificate.

  • Pre-service claim means any claim for a benefit under a group health plan with respect to which the terms of the plan condition receipt of the benefit, in whole or in part, on approval of the benefit in advance of obtaining dental care.

  • A Pre-service claim (including a Concurrent claim that also is a Pre-service claim) is considered to be filed when the request for approval of treatment or services is made and received by the Third Party Administrator in accordance with the Plan’s procedures.

  • Piedmont will review a: • Post-service claim within: 30 days after Piedmont receives it; and• Pre-service claim within: 15 days after Piedmont receives it.

  • If, due to emergency or urgency as defined above, a Pre-service claim is not possible, the Claimant must comply with the Plan’s requirements with respect to notice required after receipt of treatment, and must file the claim as a Post-service Claim, as herein described.


More Definitions of Preservice claim

Preservice claim means the request for a plan benefit(s) by a claimant prior to a service being rendered and is not considered a concurrent claim.
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Related to Preservice claim

  • Intercompany Claim means any Claim held by a Debtor against another Debtor.

  • Claim means any action, claim, obligation, liability, expense, lawsuit, demand, suit, inquiry, hearing, investigation, notice of a violation, litigation, proceeding, arbitration, or other dispute, whether civil, criminal, administrative or otherwise, whether pursuant to contractual obligations or otherwise.

  • Administrative Claim means a Claim for costs and expenses of administration of the Estates under sections 503(b), 507(a)(2), 507(b), or 1114(e)(2) of the Bankruptcy Code, including: (a) the actual and necessary costs and expenses incurred on or after the Petition Date of preserving the Estates and operating the businesses of the Debtors; (b) Allowed Professional Fee Claims in the Chapter 11 Cases; and (c) all fees and charges assessed against the Estates under chapter 123 of title 28 of the United States Code, 28 U.S.C. §§ 1911-1930.

  • DIP Claim means a Claim of the DIP Agent or DIP Lenders arising under the DIP Credit Agreement or any of the DIP Orders, including Claims for payment of DIP Expenses.

  • Infringement Claim has the meaning set forth in Section 8.2(a).