Common use of Billing of Members Clause in Contracts

Billing of Members. Under certain programs, Members may be required to pay Copayments, Coinsurance or Deductibles for certain Covered Services. Service Provider shall collect any applicable Copayments, Coinsurance and Deductibles from Members. Copayments shall be collected at the time that Covered Services are rendered. Except for applicable Copayments, Coinsurance and Deductibles, Service Provider may xxxx Members only in the following circumstances. Subject to Authority's rules, policies and procedures, services that are not Covered Services may be billed to Members by Service Provider only if: (a) the Authority confirms that the services are not covered; (b) the Members were advised prior to the services being rendered that the specific services are not Covered Services; (c) the Members agreed in writing to pay for such services, and (d) such services are pre-approved by the Authority as services that may be delivered to Members. Nothing in this section is intended to prohibit or restrict Service Provider from billing individuals who were not Members at the time that services were rendered. Nothing in this section shall prohibit Practitioners and Health Care Professionals from freely communicating with Members or guardians about all treatment options, regardless of benefit coverage limitations, which may not reflect the preferences of the Authority.

Billing of Members. Under certain programs, Members may be required to pay Copayments, Coinsurance or Deductibles for certain Covered Services. Service Provider shall collect any applicable Copayments, Coinsurance and Deductibles from Members. Copayments shall be collected at the time that Covered Services are rendered. Except for applicable Copayments, Coinsurance and Deductibles, Service Provider may xxxx bill Members only in the following circumstances. Subject to Authority's rules, policies and procedures, services that are not Covered Services may be billed to Members by Service Provider only if: (a) the Authority confirms that the services are not covered; (b) the Members were advised prior to the services being rendered that the specific services are not Covered Services; (c) the Members agreed in writing to pay for such services, and (d) such services are pre-approved by the Authority as services that may be delivered to Members. Nothing in this section is intended to prohibit or restrict Service Provider from billing individuals who were not Members at the time that services were rendered. Nothing in this section shall prohibit Practitioners and Health Care Professionals from freely communicating with Members or guardians about all treatment options, regardless of benefit coverage limitations, which may not reflect the preferences of the Authority.