Commercial Members Sample Clauses

Commercial Members. For Members enrolled in Health Plan’s Commercial HMO Product (Commercial Members), Provider will be paid at the lesser of billed charges or one of the following, less applicable Copayments: a. Health Plan’s applicable Behavioral Health Professional Fee Schedule. Covered Services not listed in accordance with rates referenced in the designated Fee Schedule will be paid at 65% of billed charges; or, b. For individual Practitioners who are affiliated with a Health Plan Medical Care Group (MCG) documented by a properly signed agreement, Health Plan shall pay Practitioner based upon the terms of Health Plan's agreement with MCG as it relates to the payment of services provide to Members assigned to MCG.

Commercial Members. For Members enrolled in BCN’s Commercial HMO Product (Commercial Members), Provider will be paid at the lesser of billed charges or (1) Health Plan’s applicable Commercial Hearing and Audiology Professional Fee Schedule or (2) any applicable separate payment agreement between Provider and Member’s referring PCP, less applicable Copayments.

Commercial Members. (a) Schedule 8.16(a) lists, for each month since January 1, 1998, the aggregate number of Commercial Members and the numbers of Commercial Members added to or deleted from the Seller's list of enrolled Commercial Members during each such month. (b) Schedule 8.16(b) contains the most recent available list of names, addresses and identification numbers for all Commercial Members and a summary fairly describing, by type and medium in which kept, all books and records maintained for the Commercial Members, including medical and claim histories, in all mediums used by the Seller, electronic or otherwise. The books and records described in Schedule 8.16(b) comprise all of the books and records required by law to be maintained by the Seller with respect to the Commercial Members and such books and records comply with all applicable legal requirements and the terms of the Commercial Contracts. (c) Schedule 8.16(c) describes each grievance and appeal received by the Seller from any Commercial Member since January 1, 1998, and generally describes the nature and status or disposition of such grievance or appeal.

Commercial Members. For Members enrolled in BCN’s Commercial HMO Product (Commercial Members), Practitioner will be paid at the lesser of billed charges or BCN’s applicable Commercial Professional Fee Schedule.

Commercial Members. For Members enrolled in Health Plan’s Commercial HMO Product (Commercial Members), Provider will be paid at the lesser of billed charges or (1) Health Plan’s applicable Professional Fee Schedule or (2) any applicable separate payment agreement between Provider and Member’s referring PCP, less applicable Copayments. Covered Services not listed on the designated Fee Schedule or applicable separate payment agreement will be paid at 65% of billed charges, less applicable Copayments.

Commercial Members. For Members enrolled in a Blue Care Network of Michigan commercial HMO product, in BCN Service Company or in Blue Care of Michigan, Inc., Practitioner will be paid at the lesser of billed charges or BCN’s applicable Commercial Professional Fee Schedule.