Common use of Accept Reimbursement Clause in Contracts

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

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

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

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

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