Copayments and Deductibles. Provider is entitled to xxxx and has the responsibility to collect from a Member any applicable copayments or deductibles for Covered Services according to the terms of this Agreement. Provider understands and agrees that because of the variety of benefit structures offered by Payers, it is not always possible to determine, in advance, the deductible or copayment amounts to be paid by Members. Furthermore, Provider understands and agrees that HPN and Payers have no responsibility to pay any amount except as described in Section 6.1 and Provider shall xxxx and collect copayments, deductibles and any other fees that are the Member’s responsibility. For health care services not covered by this Agreement or which HPN and/or Payer determine are not Medically Necessary, and for so long as not prohibited by HPN and/or Payer, Provider may xxxx Member or other responsible party, Provider shall provide notice to HPN of all such charges. Provider agrees to notify Members, in advance of providing any uncovered services that the service is not covered by the Payer Plan and that Member will be responsible for all charges.
Appears in 2 contracts
Samples: Ancillary Participation Agreement, Ancillary Participation Agreement (Certified Diabetic Services Inc)
Copayments and Deductibles. Provider is entitled to xxxx and has the responsibility to collect from a Member any applicable copayments or deductibles for Covered Services according to the terms of this Agreement. Provider understands and agrees that because of the variety of benefit structures offered by PayersSelectCare, it is not always possible to determine, in advance, the deductible or copayment amounts to be paid by Members. Furthermore, Provider understands and agrees that HPN and Payers SelectCare have no responsibility to pay any amount except as described in Section 6.1 5.1 and Provider shall xxxx and collect copayments, deductibles and any other fees that are the Member’s responsibility. For health care services not covered by this Agreement or which HPN and/or Payer determine SelectCare determines are not Medically Necessary, and for so long as not prohibited by HPN and/or PayerSelectCare, Provider may xxxx Member or other responsible party, . Provider shall provide notice to HPN SelectCare of all such charges. Provider agrees to notify Members, in advance of providing any uncovered services that the service is not covered by the Payer Plan SelectCare and that Member will be responsible for all charges.
Appears in 2 contracts
Samples: Ancillary Participation Agreement, Ancillary Participation Agreement (Certified Diabetic Services Inc)
Copayments and Deductibles. Provider is entitled to xxxx and has the responsibility to collect from a Member any applicable copayments or deductibles for Covered Services according to the terms of this Agreement. Provider understands and agrees that because of the variety of benefit structures offered by PayersPlan Benefit Programs, it is not always possible to determine, in advance, the deductible or copayment amounts to be paid by Members. Furthermore, Provider understands and agrees that HPN PMC and Payers have no responsibility to pay any amount except as described in Section 6.1 and Provider shall xxxx and collect copayments, deductibles and any other fees that are the Member’s responsibility. For health care services not covered by this Agreement or which HPN PMC and/or Payer determine are not Medically Necessary, and for so long as not prohibited by HPN PMC and/or Payer, Provider may xxxx Member or other responsible party, . Provider shall provide notice to HPN PMC of all such charges. Provider agrees to notify Members, in advance of providing any uncovered services that the service is not covered by the Payer Plan Benefit Program and that Member will be responsible for all charges.
Appears in 1 contract
Samples: Ancillary Participation Agreement (Certified Diabetic Services Inc)