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.
Sample 1Sample 2Sample 3
Service Claim means any Claim for benefits under this Contract that is not a Pre-Service Claim.
Sample 1Sample 2Sample 3
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
Sample 1Sample 2

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.

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

  • 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.

  • If the appeal is filed after the additional treatment has been provided, the Post- Service Claim time applies.


More Definitions of Service Claim

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;
Sample 1
Service Claim has the meaning ascribed to such term in Section 8.14(a) hereof.
Sample 1

Related to Service Claim

  • Pre-Service Claim means a claim for a medical care benefit with respect to which the plan conditions receipt of the benefit, in whole or in part, on approval of the benefit in advance of receipt of care.

  • Post-Service Claim means a claim for payment for medical care that already has been provided.

  • Cure Claim means a monetary Claim based upon the Debtors’ defaults under any Executory Contract or Unexpired Lease at the time such contract or lease is assumed by the Debtors pursuant to section 365 of the Bankruptcy Code.

  • Rejection Claim means a Claim arising from the rejection of an Executory Contract or Unexpired Lease pursuant to section 365 of the Bankruptcy Code.

  • Urgent Care Claim means a claim for medical care or treatment where making a non-urgent care decision: (a) could seriously jeopardize the life or health of the claimant or the ability of the claimant to regain maximum function, as determined by an individual acting on behalf of the plan applying the judgment of a prudent layperson who possesses an average knowledge of health and medicine; or (b) in the opinion of a physician with knowledge of the claimant’s medical condition, would subject the claimant to severe pain that cannot be adequately managed without the care.

  • Convenience Claim means a Claim that would otherwise be an Other Unsecured Claim that is

  • Preference Claim As defined in Section 4.02 hereof.

  • Service Call A visit to Your Property by one of HomeServe’s approved local technicians, where work is performed to diagnose and complete a single covered repair, or where it is determined the repair is not covered.

  • AWR Claim means any complaint or claim to a tribunal or court made by or on behalf of the Agency Worker against the Hirer and/or the Employment Business for any breach of the AWR;

  • Third Party Claim has the meaning set forth in Section 9.5(a).

  • Tax Claim has the meaning set forth in Section 6.05.

  • 503(b)(9) Claim means a Claim or any portion thereof entitled to administrative expense priority pursuant to section 503(b)(9) of the Bankruptcy Code.

  • Relevant Claim means a claim by the Buyer under or pursuant to the provisions of clause 9.1 or the Tax Deed or any other provision of this Agreement or the Other Documents;

  • Disputed Claim means any Claim that is not Allowed.

  • IPR Claim means any claim of infringement or alleged infringement (including the defence of such infringement or alleged infringement) of any IPR, used to provide the Services or as otherwise provided and/or licensed by the Supplier (or to which the Supplier has provided access) to the Authority in the fulfilment of its obligations under this Framework Agreement;

  • Third party claimant means any individual, corporation, association, partnership, or other legal entity asserting a claim against any individual, corporation, association, partnership, or other legal entity insured under an insurance policy or insurance contract.

  • Third Person Claim has the meaning specified in Section 11.4(a).

  • Settlement Claim means a claim for settlement benefits made under the terms of this Settlement Agreement.

  • Payment Initiation Service Provider or “PISP” means an authorised third party provider which provides a service that allows that third party to pass payment instructions to us on your behalf in relation to your Account.

  • Toll Billing Exception Service (TBE means a service that allows End Users to restrict third number billing or collect calls to their lines.

  • Billing Party means the Party rendering a bill.

  • 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.

  • Professional Fee Claim means a Claim by a professional seeking an award by the Bankruptcy Court of compensation for services rendered or reimbursement of expenses incurred through and including the Confirmation Date under sections 330, 331, 503(b)(2), 503(b)(3), 503(b)(4), or 503(b)(5) of the Bankruptcy Code.

  • Clean Claim means a claim that:

  • Professional Claim means an Administrative Claim of a Professional for compensation for services rendered or reimbursement of costs, expenses, or other charges and disbursements incurred relating to services rendered or expenses incurred after the Petition Date and prior to and including the Confirmation Date.

  • Service Outage means an instance when the Customer is unable to route traffic to one or more Customer Sites via the Network, which results in Service Downtime;