Charges to Members. (a) In no event, including without limitation nonpayment by Blue Shield, or Blue Shield’s insolvency or breach of this Agreement, shall Provider bill, charge, collect a deposit from, impose a surcharge on, seek compensation, remuneration or reimbursement from, or have any recourse against, a Member, or any individual responsible for such Member’s care, for Covered Services. Without limiting the foregoing, Provider shall not seek payment from a Member, or any individual responsible for such Member’s care, for Covered Services for which payment was denied by Blue Shield because the bill or claim for such Covered Services was not timely or properly submitted. If Blue Shield receives notice of a violation of this Section, it shall have the right to take all appropriate action, including without limitation, the right, following thirty (30) days written notice to Provider, to reimburse the Member for the amount of any payment made and to offset the amount of such payment from any amounts then or thereafter owed by Blue Shield to Provider.
Charges to Members. (a) In no event, including but not limited to nonpayment by Blue Shield or Group, or Blue Shield’s or Group’s insolvency or breach of this Agreement (or breach by Group of its agreement with Group Provider), shall Group and Group Providers xxxx, charge, collect a deposit from, impose a surcharge on, seek compensation, remuneration or reimbursement from or have any recourse against, Members or an individual responsible for their care for Covered Services. Nor shall Group or a Group Provider seek payment from Members or individuals responsible for their care, for payments for Covered Services denied by Blue Shield or Group because such xxxx or claim was not timely or properly submitted, or because the rendered services were not Medically Necessary or Authorized. Whenever Blue Shield receives notice of a violation of this Paragraph 8.3, it shall take appropriate action (including without limitation the right to reimburse the Member the amount of any payment and offset the amount of such payment from any amounts then or thereafter owed by Blue Shield to Group).
Charges to Members. (a) In no event, including without limitation nonpayment by Health Plan, or Health Plan’s insolvency or breach of this Agreement, shall Provider bill, charge, collect a deposit from, impose a surcharge on, seek compensation, remuneration or reimbursement from, or have any recourse against, a Member, or any individual responsible for such Member’s care, for Covered Services. Without limiting the foregoing, Provider shall not seek payment from a Member, or any individual responsible for such Member’s care, for Covered Services for which payment was denied by Health Plan because the bill or claim for such Covered Services was not timely or properly submitted. If Health Plan receives notice of a violation of this Section, it shall have the right to take all appropriate action, including without limitation, the right, following thirty (30) days’ written notice to Provider, to reimburse the Member for the amount of any payment made and to offset the amount of such payment from any amounts then or thereafter owed by Health Plan to Provider.
Charges to Members. Physician will look only to Plan for compensation for Covered Services, except that Physician may seek compensation from or make surcharges to a Member for i) services other than Covered Services, or ii) co-payments or deductibles identified in the applicable Plan Schedules.
Charges to Members. Plan requires Members to pay applicable copayments for certain Covered Services at the time services are rendered. It is the responsibility of Members to pay such copayments at the time services are received. If a Member fails to pay co-payments, Group shall inform Plan immediately. Group shall indemnify and hold Plan, and Members harmless from any costs, including legal fees, relating to improper billing practices or effects which breach the terms of this Agreement or pursuant to any of it Subcontractors.
Charges to Members a. Costs shall be allocated among Members as shown in Exhibit B, except as otherwise provided in this Section. Cost allocations in Exhibit B are based on phosphorus load reductions and are determined by multiplying the total adaptive management project cost by the fraction of the total pounds of required project phosphorus reduction needed by each Member to meet its TMDL allocation under current conditions. For example, if the required phosphorus reduction of an individual member is equal to 5 percent of the total pounds of phosphorus reduction from all sources in this adaptive management project, that member is assigned 5 percent of the total project cost. For the purpose of Exhibit B, required phosphorus reductions were determined as follows:
Charges to Members. In no event will the charge to a Member for Deductibles, Coinsurance or Copayments exceed the amounts established by Regence or Payor, subject to the terms of the “Coordination of Benefits” section of the Agreement. The referenced section of the Agreement is deleted in its entirety and replaced with the following:
Charges to Members. The Group agrees to require that Group Physicians will look only to the Plan for compensation for Covered Services, except that Group Physicians may seek compensation from or make surcharges to a Member for i) services other than Covered Services, or ii) co-payments, coinsurance or deductibles identified in the applicable Plan Schedules.
