Copayments. Provider shall collect and retain a Member’s applicable Copayment for Covered Services provided pursuant to this Agreement. Provider shall not waive a Member’s Copayment obligation. Notwithstanding the foregoing, Provider acknowledges that cost sharing for Members eligible for both Medicare and Medicaid/Medi-Cal (“Dual Eligible Members”) is limited to the cost sharing limits established by Medicaid/Medi-Cal. With respect to Covered Services provided to Dual Eligible Members, Provider shall accept payment by Blue Shield as payment-in-full for such Covered Services, or will separately bill the appropriate State source for any amounts above the Medicaid/Medi-Cal cost sharing limits.
Appears in 7 contracts
Samples: Independent Provider Agreement, Independent Provider Agreement, Provider Agreement
Copayments. Provider shall collect and retain retain, as additional compensation, a Member’s applicable Copayment for Covered Services provided pursuant to this Agreement. Provider shall not waive a Member’s Copayment obligation. Notwithstanding the foregoing, Provider acknowledges that cost sharing for Members eligible for both Medicare and Medicaid/Medi-Medi- Cal (“Dual Eligible Members”) is limited to the cost sharing limits established by Medicaid/Medi-Cal. With respect to Covered Services provided to Dual Eligible Members, Provider shall accept payment by Blue Shield as payment-in-full for such Covered Services, or will separately bill the appropriate State source for any amounts above the Medicaid/Medi-Cal cost sharing limits.
Appears in 2 contracts
Samples: Allied & Ancillary Provider Agreement, Allied & Ancillary Provider Agreement
Copayments. Provider shall collect and retain a Member’s applicable Copayment for Covered Services provided pursuant to this Agreement. Provider shall not waive a Member’s Copayment obligation. Notwithstanding the foregoing, Provider acknowledges that cost sharing for Members eligible for both Medicare and Medicaid/Medi-Cal (“Dual Eligible Members”) is limited to the cost sharing limits established by Medicaid/Medi-Cal. With respect to Covered Services provided to Dual Eligible Members and Medi-Cal Members, Provider shall accept payment by Blue Shield Health Plan as payment-in-full for such Covered Services, Services or will separately bill the appropriate State source for any amounts above the Medicaid/Medi-Medi- Cal cost sharing limits.
Appears in 2 contracts
Samples: Provider Agreement, Provider Agreement
Copayments. Provider shall collect and retain a Member’s applicable Copayment for Covered Services provided pursuant to this Agreement. Provider shall not waive a Member’s Copayment obligation. Notwithstanding the foregoing, Provider acknowledges that cost sharing for Members eligible for both Medicare and Medicaid/Medi-Cal (“Dual Eligible Members”) is limited to the cost sharing limits established by Medicaid/Medi-Cal. With respect to Covered Services provided to Dual Eligible Members, Provider shall accept payment by Blue Shield as payment-in-full for such Covered Services, or will separately bill xxxx the appropriate State source for any amounts above the Medicaid/Medi-Cal cost sharing limits.
Appears in 1 contract
Samples: Independent Provider Agreement