Vision Claim Form definition

Vision Claim Form means the Benefit Trust Fund’s standard form used to submit a vision claim for consideration under the Plan.
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Examples of Vision Claim Form in a sentence

  • You can also send a completed Vision Claim Form to: VSPPO Box 385018Birmingham, AL 35238-5018My BlueprintVisit arkansasbluecross.com to register for My Blueprint.

  • Read the Otsego Public Schools Vision Claim Form completely to understand what data will be required of you.

  • How to Claim Vision Expense Benefits Claims for covered eyewear and/or eye exams must be submitted to Green Shield on a fully completed Vision Claim Form along with the original receipt(s) and must be submitted within 12 months of the date of purchase or service to be considered for reimbursement.VI.

  • To download a claim form, log in at unicare.com, or from the home page menu under Customer Support select Download Forms, scroll down under the heading for Claims and select Vision Claim Form.

  • If submitting your own vision claims, obtain an itemized statement from the vision provider’s office including provider name and address, attach aHow to File a Claim (continued) copy to a completely filled out ADN Vision Claim Form.

  • You can also send a completed Vision Claim Form to: VSPPO Box 385018Birmingham, AL 35238-5018Blueprint PortalVisit arkansasbluecross.com to register for Blueprint Portal.

  • You can obtain the Vision Claim Form by calling Wilson-McShane Corporation at 952-851-5948.

  • How to Claim Vision Expense Benefits Claims for covered eyewear and/or eye exams must be submitted to Green Shield on a fully completed Vision Claim Form along with the original receipt(s) and must be submitted within 12 months of the date of purchase or service to be considered for reimbursement.

  • Expense Item(s) The applicant will select the expense item(s) on a given FCC Form 462 for which it seeks a substitution and enter the new information.

  • Generally, vision providers will xxxx Xxxxx Shield directly by submitting a Green Shield Vision Claim Form.

Related to Vision Claim Form

  • Claim Form or “Proof of Claim Form” means the form, substantially in the form attached hereto as Exhibit 2 to Exhibit A, that a Claimant must complete and submit should that Claimant seek to share in a distribution of the Net Settlement Fund.

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

  • Litigation Claims means the claims, rights of action, suits or proceedings, whether in law or in equity, whether known or unknown, that any Debtor or any Estate may hold against any Person or Entity, including, without limitation, the Causes of Action of the Debtors or their Estates, in each case solely to the extent of the Debtors’ or their Estates’ interest therein. A non-exclusive list of the Litigation Claims held by the Debtors as of the Effective Date will be Filed with the Plan Supplement, which will be deemed to include any derivative actions filed against any Debtor as of the Effective Date.

  • Indemnification Claim has the meaning set forth in Section 12.3.

  • Indemnification Claim Notice has the meaning set forth in Section 11.3.

  • Administrative Claim Bar Date means the deadline for filing requests for payment of Administrative Claims, which shall be 30 days after the Effective Date.

  • Disputed Claim means any Claim that is not Allowed.

  • 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.

  • 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.

  • Allowed Administrative Claim means an Allowed Claim that is an Administrative Claim.

  • Notice and Claims Agent means Prime Clerk LLC.

  • Expected Claim Notice means a notice that, as a result of a legal proceeding instituted by or written claim made by a third party, an Indemnified Party reasonably expects to incur Damages for which it is entitled to indemnification under Article VI.

  • Claim for Benefits means a request for a Plan benefit or benefits made by a Member in accordance with the Plan’s Appeals Procedures, including any Pre-Service Claims (requests for Prior Authorization) and Post-Service Claims (requests for benefit payment).

  • Administrative Claims Bar Date means the deadline for Filing requests for payment of Administrative Claims, which: (a) with respect to Administrative Claims other than Professional Fee Claims, shall be 30 days after the Effective Date; and (b) with respect to Professional Fee Claims, shall be 45 days after the Effective Date.

  • Proven Claim means (a) a Claim of a Creditor, Finally Determined as an Allowed Claim for voting, distribution and payment purposes under the Plan, (b) in the case of the Participating CCAA Parties in respect of their CCAA Party Pre-Filing Interco Claims, and in the case of the Non-Filed Affiliates in respect of their Non-Filed Affiliate Unsecured Interco Claims and Non- Filed Affiliate Secured Interco Claims, as such Claims are declared, solely for the purposes of the Plan, to be Proven Claims pursuant to and in the amounts set out in the Amended and Restated Meetings Order, and (c) in the case of Employee Priority Claims and Government Priority Claims, as Finally Determined to be a valid post-Filing Date claim against a Participating CCAA Party;

  • First party claimant means an individual, corporation, association, partnership or other legal entity asserting a right to payment under an insurance policy or insurance contract arising out of the occurrence of the contingency or loss covered by such policy or contract;

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

  • Proof of Claim and Release means the Proof of Claim and Release form for submitting a Claim, which, subject to approval of the Court, shall be substantially in the form attached hereto as Exhibit A-2, that a Class Member must complete and submit should that Class Member seek to share in a distribution of the Net Settlement Fund.

  • Claims Agent means Kurtzman Carson Consultants LLC.

  • Authorized Claimant means any Class Member whose claim for recovery has been allowed pursuant to the terms of the Stipulation.

  • Clean Claim means a claim that:

  • Indemnity Claim has the meaning set forth in Section 8.3.

  • Claims Notice has the meaning set forth in Section 9.3(a).

  • Insured Claim means any Claim arising from an incident or occurrence alleged to have occurred prior to the Effective Date that is covered under an insurance policy applicable to the Debtors or their businesses.

  • Claimants means any Persons who have submitted a Claim to the Receiver or to the Joint Liquidators.

  • Proof of Claim means a proof of Claim Filed against any of the Debtors in the Chapter 11 Cases.