Service Claim definition

Service Claim means any Claim for benefits under this Contract for which, in whole or in part, a Claimant must obtain authorization from AvMed in advance of such services being provided to or received by the Member.

Service Claim means any Claim for benefits under this Contract that is not a Pre-Service Claim.

Service Claim means any debt or sum required to make good any loss, deficiency or irregular expenditure of service money pertaining to any service mess, club, institution or other service organization for which, after due investigation, no explanation satisfactory to the Minister is given by the person responsible for the same; and

Examples of Service Claim in a sentence

• The form will give You instructions for filing the Post- Service Claim.

• We will deny any Post- Service Claim not received within this time limit.

• Within 60 days after receipt of the grievance for a case involving a Post- Service Claim; and In the case of an expedited appeal regarding a claim relating to a prescription for the alleviation of cancer pain, the appeal decision shall be made as soon as possible but no later than 24 hours after receipt of the appeal.

• Post Service Claim A request for payment of benefits that is made by you or your authorized representative after services are rendered and in accordance with the procedures described in this contract.

• A Pre- Service Claim is any claim for a medical, prescription drug, dental or vision care benefit which the appropriate Plan terms condition the Covered Person’s receipt of the benefit, in whole or in part, on approval of the benefit before obtaining treatment.

• Expedited Appeals are not available for appeals regarding denied claims for benefit payment (Post- Service Claim) or for Pre-Service Claims that are not Urgent Care Claims.

• It is the responsibility of the Member to make certain each Post‐Service Claim submitted by him or on his behalf includes all information necessary to process the claim, and that the Post‐ Service Claim is sent to the proper address for processing (the address on the Member’s ID card).

• You may submit a Post- Service Claim if You are asked to pay the full cost of the prescription drug when You fill it and You believe that the Plan should have paid for it or You believe that the Co- payment amount was incorrect.

• Contact the Service Organization's Customer Service Department for the proper Post- Service Claim forms.

• Under the terms of the Prior Service Claim Adjudication Service Agreement between the Prior Service Trust Fund Administration and the Social Security Administration of the Federated States of Micronesia, the FSM Social Security Administration is to provide for the processing of benefit claims and to assist in the monitoring of continuing eligibility under the Prior Service Program.

More Definitions of Service Claim

Service Claim has the meaning ascribed to such term in Section 8.14(a) hereof.

Service Claim means any service debt or sum required to make good any loss, deficiency or irregular expenditure of service money of which, after due investigation, no explanation satisfactory to the Defence Board is given by the person who is responsible for the same;