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claim form

   Also found in: Medical, Legal, Financial, Encyclopedia, Wikipedia, Hutchinson 0.03 sec.
ThesaurusLegend:  Synonyms Related Words Antonyms
Noun1.claim form - a form to use when filing a claim
form - a printed document with spaces in which to write; "he filled out his tax form"
Translations
claim form

claim form n (gen) → modulo di richiesta; (for expenses) → modulo di rimborso spese
claim form n (gen) → modulo di richiesta; (for expenses) → modulo di rimborso spese

claim form استمارة مطالبة formulář pro hlášení škod skadeanmeldelse Antragsformular αίτηση αποζήμίωσης formulario de reclamación, impreso de reclamación korvaushakemus formulaire de réclamation obrazac za potraživanje modulo di richiesta クレームフォーム 청구서 claimformulier skadeskjema formularz roszczenia formulário de sinistro бланк заявления о выплате страхового возмещения stämningsansökan แบบฟอร์มการเรียกร้อง istek formu mẫu đề nghị 催询单


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? Mentioned in ? References in periodicals archive
 
When billing a carrier for the cost of returning a patient to the operating room for management of a complication, you should use modifier 78 on the claim form.
Q: Can we bill a glucose charge on the same claim form as therapy and prosthetics, or does the glucose need to be on a separate claim?
Each proof of Administrative Expense must conform substantially to the claim form that has been approved by the Bankruptcy Court.
 
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