Common use of Accept Reimbursement Clause in Contracts

Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Blue Choice PPO Members the lesser of Groups Usual Charge or The Plans Maximum Reimbursement Allowance set forth in Article III and hold Blue Choice PPO Members harmless from any sums in excess of this Maximum Reimbursement Allowance. Group may collect from the Blue Choice PPO Member any amounts for Noncovered Services and the applicable copayment and deductible unless prohibited by law. Until The Plan has determined the Maximum Reimbursement Allowance and notified Group as to the amount due from the Blue Choice PPO Member, if any, under the Blue Choice PPO Members Benefit Agreement, Group shall not bill or attempt to collect from the Blue Choice PPO Member any coinsurance amounts. The total amount collected from The Plan, or administered accounts, and the Blue Choice PPO Member for copayment, deductible and coinsurance, but not including Noncovered Services, may not exceed the lesser of Groups Usual Charge or The Plans Maximum Reimbursement Allowance. Group agrees to promptly refund to the Blue Choice PPO Member any amounts which may have been collected from the Blue Choice PPO Member in excess of the Blue Choice PPO Members responsibility as shown on The Plans provider claims summary.

Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Blue Choice PPO BlueLincs HMO Members the lesser of Groups Group's Usual Charge or The Plans BlueLincs HMO's Maximum Reimbursement Allowance set forth in Article III IV and hold Blue Choice PPO BlueLincs HMO Members harmless from any sums in excess of this Maximum Reimbursement Allowance. Group may collect from the Blue Choice PPO BlueLincs HMO Member any amounts for Noncovered Services and the applicable copayment and deductible unless prohibited by law. Until The Plan BlueLincs HMO has determined the Maximum Reimbursement Allowance and notified Group as to of the amount due from the Blue Choice PPO BlueLincs HMO Member, if any, under the Blue Choice PPO Members BlueLincs HMO Member's Benefit Agreement, Group shall not bill or attempt to collect from the Blue Choice PPO BlueLincs HMO Member any coinsurance amounts. The total amount collected from The PlanBlueLincs HMO, or administered accounts, and the Blue Choice PPO BlueLincs HMO Member for copayment, deductible and coinsurance, but not including Noncovered Services, may not exceed the lesser of Groups Group's Usual Charge or The Plans BlueLincs HMO's Maximum Reimbursement Allowance. Group agrees to promptly refund to the Blue Choice PPO BlueLincs HMO Member any amounts which may have been collected from the Blue Choice PPO BlueLincs HMO Member in excess of the Blue Choice PPO Members BlueLincs HMO Member's responsibility as shown on The Plans BlueLincs HMO's provider claims summary.

Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Blue Choice Preferred PPO Members Members, the lesser of Groups Group's Usual Charge or The Plans Plan's Maximum Reimbursement Allowance set forth in Article III and hold Blue Choice Preferred PPO Members harmless from any sums in excess of this Maximum Reimbursement Allowance. Group may collect from the Blue Choice Preferred PPO Member any amounts for Noncovered Services and the applicable copayment and deductible unless prohibited by law. Until The Plan has determined the Maximum Reimbursement Allowance and notified Group as to the amount due from the Blue Choice Preferred PPO Member, if any, under the Blue Choice Preferred PPO Members Member's Benefit Agreement, Group shall not bill or attempt to collect from the Blue Choice Preferred PPO Member any coinsurance amounts. The total amount collected from The Plan, or administered accounts, and the Blue Choice Preferred PPO Member for copayment, deductible and coinsurance, but not including Noncovered Services, may not exceed the lesser of Groups Group's Usual Charge or The Plans Plan's Maximum Reimbursement Allowance. Group agrees to promptly refund to the Blue Choice Preferred PPO Member any amounts which may have been collected from the Blue Choice Preferred PPO Member in excess of the Blue Choice Preferred PPO Members Member's responsibility as shown on The Plans Plan's provider claims summary.

Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Blue Choice Advantage PPO Members the lesser of Groups Usual Charge or The Plans Maximum Reimbursement Allowance set forth in Article III and hold Blue Choice Advantage PPO Members harmless from any sums in excess of this Maximum Reimbursement Allowance. Group may collect from the Blue Choice Advantage PPO Member any amounts for Noncovered Services and the applicable copayment and deductible unless prohibited by law. Until The Plan has determined the Maximum Reimbursement Allowance and notified Group as to the amount due from the Blue Choice Advantage PPO Member, if any, under the Blue Choice Advantage PPO Members Benefit Agreement, Group shall not bill or attempt to collect from the Blue Choice Advantage PPO Member any coinsurance amounts. The total amount collected from The Plan, or administered accounts, and the Blue Choice Advantage PPO Member for copayment, deductible and coinsurance, but not including Noncovered Services, may not exceed the lesser of Groups Usual Charge or The Plans Maximum Reimbursement Allowance. Group agrees to promptly refund to the Blue Choice Advantage PPO Member any amounts which may have been collected from the Blue Choice Advantage PPO Member in excess of the Blue Choice Advantage PPO Members responsibility as shown on The Plans provider claims summary.