Common use of Authorized Services Clause in Contracts

Authorized Services. In some circumstances, such as where there is no In-Network Provider available for the Covered Service, we may authorize the In-Network cost share amounts (Deductible, Copayment, and/or Coinsurance) to apply to a claim for a Covered Service you receive from an Out-of-Network Provider. In such circumstance, you must contact us in advance of obtaining the Covered Service. We also may authorize the In-Network cost share amounts to apply to a claim for Covered Services if you receive Emergency Services from an Out-of-Network Provider and are not able to contact us until after the Covered Service is rendered. If we authorize a Covered Service so that you are responsible for the In-Network cost share amounts, you may still be liable for the difference between the Maximum Allowed Cost (MAC) and the Out-of-Network Provider’s charge. Please contact Customer Service for Authorized Services information or to request authorization.

Authorized Services. In some circumstances, such as where there is no In-Network Provider available for the Covered Service, we We may authorize the Inin-Network network cost share amounts (Deductible, Copayment, and/or Coinsurance) to apply to a claim for a Covered Service you You receive from an Out-of-Network Provider. In such circumstance, you You must contact us Us in advance of obtaining the Covered Service. We also may authorize the Inin-Network network cost share amounts to apply to a claim for Covered Services if you You receive Emergency Services from an Out-of-Network Provider and are not able to contact us Us until after the Covered Service is rendered. If we We authorize a Covered Service so that you You are responsible for the Inin-Network network cost share amounts, you You may still be liable for the difference between the Maximum Allowed Cost (MAC) MAC and the Out-of-Network Provider’s charge. Please contact Customer Service at (000)000-0000 for Authorized Services information or to request authorization.

Authorized Services. In some circumstances, such as where there is no In-Network Provider available for the Covered Service, we We may authorize the Inin-Network network cost share amounts (Deductible, Copayment, and/or Coinsurance) to apply to a claim for a Covered Service you You receive from an Out-of-Network Provider. In such circumstance, you You must contact us Us in advance of obtaining the Covered Service. We also may authorize the Inin-Network network cost share amounts to apply to a claim for Covered Services if you You receive Emergency Services from an Out-of-Network Provider and are not able to contact us Us until after the Covered Service is rendered. If we We authorize a Covered Service so that you You are responsible for the Inin-Network network cost share amounts, you You may still be liable for the difference between the Maximum Allowed Cost (MAC) MAC and the Out-of-Network Provider’s charge. Please contact Customer Service at (000) 000-0000 for Authorized Services authorized services information or to request authorization.

Authorized Services. In some circumstances, such as where there is no In-Network Provider available for the Covered Service, we may authorize the Inin-Network network cost share amounts (Deductible, Copayment, and/or Coinsurance) to apply to a claim for a Covered Service you receive from an Out-of-Network Provider. In such circumstance, you must contact us in advance of obtaining the Covered Service. We also may authorize the Inin-Network network cost share amounts to apply to a claim for Covered Services if you receive Emergency Services from an Out-of-Network Provider and are not able to contact us until after the Covered Service is rendered. If we authorize a Covered Service so that you are responsible for the Inin-Network network cost share amounts, you may still be liable for the difference between the Maximum Allowed Cost (MAC) MAC and the Out-of-Network Provider’s charge. Please contact Customer Service at (000) 000-0000 for Authorized Services information or to request authorization.

Authorized Services. In some circumstances, such as where there is no In-Network Provider available for the Covered Service, we may authorize the Inin-Network network cost share amounts (Deductible, Copayment, and/or Coinsurance) to apply to a claim for a Covered Service you receive from an Out-of-Network Provider. In such circumstance, you must contact us in advance of obtaining the Covered Service. We also may authorize the Inin-Network network cost share amounts to apply to a claim for Covered Services if you receive Emergency Services from an Out-of-Network Provider and are not able to contact us until after the Covered Service is rendered. If we authorize a Covered Service so that you are responsible for the Inin-Network network cost share amounts, you may still be liable for the difference between the Maximum Allowed Cost (MAC) MAC and the Out-of-Network Provider’s charge. Please contact Customer Service at (000) 000-0000 for Authorized Services authorized services information or to request authorization.